The case for Chronotherapy in COVID-19 induced Acute Respiratory
Distress Syndrome (ARDS).
Abstract
COVID-19, the disease resulting from infection by a novel coronavirus:
SARS-Cov2 that has rapidly spread since November 2019 leading to a
global pandemic. SARS-Cov2 has infected over 2.8 million people and
caused over 180,000 deaths worldwide. Although most cases are mild, a
subset of patients develop a severe and atypical presentation of Acute
Respiratory Distress Syndrome (ARDS) that is characterised by a cytokine
release storm (CRS). Paradoxically, treatment with anti-inflammatory
agents and immune regulators has been associated with worsening of ARDS.
We hypothesize that the intrinsic circadian clock of the lung and the
immune system may regulate individual components of CRS and thus
chronotherapy may be used to effectively manage ARDS in COVID-19
patients.