Cytokine Storm and Mucus Hypersecretion in COVID-19: Review of Mechanisms

Khan, Mohsin Ali; Khan, Zaw Ali; Charles, Mark; Pratap, Pushpendra; Naeem, Abdul; Siddiqui, Zainab; Naqvi, Nigar; Srivastava, Shikha

Mucus is an integral part of the respiratory physiology. It protects the respiratory tract by acting as a physical barrier against inhaled particles and microbes. Excessive inflammation in conditions such as COVID-19 can result in over-production of mucus which obstructs the airway. Build-up of mucus can also contribute to recurrent airway infection, causing further obstruction. This article summarizes the current understanding and knowledge of respiratory mucus production and proposes the role of cytokine storm in inducing sudden mucus hypersecretion in COVID-19. Based on these cascades, the active constituents that inhibit or activate several potential targets are outlined for further research. These may be explored for the discovery and design of drugs to combat cytokine storm and its ensuing complications.