ABSTRACT
BACKGROUND: Two years have passed since the WHO declared a pandemic state for SARS-CoV2 infection. COVID-19 pathogenesis consists of a first viral phase responsible for early symptoms followed by an inflammatory phase, which is cytokine-mediated, responsible for late-onset signs up to acute respiratory distress syndrome. Considering that interleukin (IL)6 plays a key role in the development and maintenance of inflammation, drugs targeting both IL6 and IL6 receptors have been evaluated. CASE REPORTS: The present study reports the cases of two hospitalized patients with severe respiratory COVID-19 treated with a single dose of intravenous sarilumab, a monoclonal anti-IL6 antibody, along with standard of care medications and high-flow oxygen therapy. Although a few days following sarilumab administration, clinical and biochemical conditions started ameliorating, these patients developed severe and self-limiting neutropenia. CONCLUSION: Sarilumab may represent a promising weapon to treat the fearsome hyperinflammatory phase;however, more trials are needed to decide whether to use it in combination with other drugs or alone, and to better understand pharmacokinetics and side effects.
ABSTRACT
Patients with sickle cell disease (SCD) are more susceptible to severe coronavirus disease 2019 (COVID-19) infection, in comparison with the general population, due to the possibility that the inflammatory state, along with hypoxia and hypercoagulability may increase the risk of developing acute SCD-related complications. The present study reports the case of a 33-year-old female affected by SCD, who although vaccinated against COVID-19, tested positive for SARS-CoV-2 and developed febrile pneumonia. During hospitalization, the patient complained about generalized intense pain, along with fever recurrence and increased inflammatory marker, procalcitonin and haemoglobin S levels. The patient was treated with an intravenous analgesic therapeutics cocktail in combination with red blood cell manual exchange procedure and broad-spectrum antibiotic therapy, achieving the rapid resolution of pain and an improvement in the laboratory test results. From the case presented herein, it is thus suggested that patients with SCD and COVID-19 infection need to be critically evaluated by clinicians, as such patients may develop severe outcomes, attributed to the overlap of two difficult to treat conditions. © 2022 by the authors.
ABSTRACT
COVID-19 has devastated healthcare systems all over the world and is still raging in Italy. In many countries, patients with chronic illnesses are suffering from delay in diagnostic and treatment management. We report a challenging case of a HIV patient who experienced delay in diagnosis of multiple myeloma due to COVID-19 pandemic restrictions. Global cooperation to ensure equity and responsiveness to local contexts is essential on the difficult path ahead to ending the COVID-19 pandemic, as treatment for one potentially curable disease should not be performed at the expense of another.
ABSTRACT
Since late 2019, SARS-CoV2 has spread worldwide, leading the WHO to declare a pandemic state. Italy was deeply affected by the virus, particularly North Italy. Several molecules have been tested for the treatment of coronavirus disease (COVID-19), comparing the treatment efficacy and collateral effects. To date, no antiviral drugs have been approved for the treatment of the COVID-19 viral phase or for the inflammatory phase. Undoubtedly, oxygen support plays a key role in the management of patients affected by this virus. The present study reports the cases of 3 patients critically ill with COVID-19. Despite antiviral therapy, their clinical conditions deteriorated a few days following admis- sion, particularly as regards respiratory performance, together with chest X-ray findings and arterial blood gas parameters. The levels of inflammatory markers were also elevated. The patients were treated with high-flow nasal cannula (HFNC) oxygenation along with a double dose of tocilizumab. A few days following HFNC and tocilizumab administration, the respiratory rates and arterial blood gas data were ameliorated alongwithchestX-rayresults.TheuseofHFNCwasthenslowly reduced until it was terminated, with the patients achieving a successful discharge. On the whole, as presented herein, it is indisputable more data and guidelines for COVID-19 therapies are warranted in order to guide clinicians as to the appropriate clinical treatment which will guarantee an optimal therapeutic response. © 2020 World Academy of Sciences Journal. All rights reserved.