COVID-19 inflammation and implications in drug delivery

Growing evidence indicates that hyperinflammatory syndrome and cytokine storm observed in COVID-19 severe cases are narrowly associated with the disease’s poor prognosis. Therefore, targeting the inflammatory pathways seems to be a rational therapeutic strategy against COVID-19. Many anti-inflammatory agents have been proposed; however, most of them suffer from poor bioavailability, instability, short half-life, and undesirable biodistribution resulting in off-target effects. From a pharmaceutical standpoint, the implication of COVID-19 inflammation can be exploited as a therapeutic target and/or a targeting strategy against the pandemic. First, the drug delivery systems can be harnessed to improve the properties of anti-inflammatory agents and deliver them safely and efficiently to their therapeutic targets. Second, the drug carriers can be tailored to develop smart delivery systems able to respond to the microenvironmental stimuli to release the anti-COVID-19 therapeutics in a selective and specific manner. More interestingly, some biosystems can simultaneously repress the hyperinflammation due to their inherent anti-inflammatory potency and endow their drug cargo with a selective delivery to the injured sites. Drug delivery systems can be harnessed to fight against SARS-CoV-2 induced hyperinflammation by improving the properties of anti-inflammatory agents, smartly responding to the inflammatory site to selectively deliver their cargo, and may possess inherent anti-inflammatory potency. [Display omitted] •Hyperinflammatory syndrome and cytokine storm are narrowly associated with COVID-19 poor prognosis.•Targeting the inflammatory pathways is a rational therapeutic strategy to combat COVID-19.•Drug delivery systems can be harnessed to improve the properties of anti-inflammatory agents.•Drug delivery systems can be tailored to smartly respond to the specific stimuli of the inflammatory microenvironment.•Biomimetics and mesenchymal stem cells are promising therapeutics and drug carriers against COVID-19.