EFFICACY OF OLOCIZUMAB IN TREATMENT OF COVID-19 PATIENTS

Background. Production of pro-inflammatory cytokines includinginter leukin 6(IL-6) is activated in COVID-19. Using olokizumab which inhibits IL-6 production in treatment of COVID-19 is pathogenetically justified. The aim. To study in real clinical practice the efficacy and safety of using the IL-6 inhibitor (olokizumab) intreatmen tofpatients with confirmed COVID-19pneumonia. Materials andmethods. The first group included 41 hospitalized patients with confirmed COVID-19 pneumonia having complex therapy including olokizumab. The control group consisted of 66 patients with confirmed COVID-19 pneumonia who did not have therapy with IL-6 inhibitor. We analyzed clinical (volume of lung involvement, respiratory failure degree, body mass index)andlaboratory data (levels of T-troponin, lactate, procalcitonin, natriuretic peptide, C-reactive protein, fibrinogen, D-dimer, ferritin, erythrocyte sedimentation rate, glomerular filtration rate). Results. The groups didnotdiffer in gender, age, body mass index of patients, volume of lung tissue injury, and duration of hospitalization (p > 0.05). Respiratory failure of 2-3rd degree was more common in patients of the first group (χ2 = 6.3;p = 0.010). The initial levels of C-reactive protein (50.9 [34.2;76.2] and 32.2 [9.9;69.1] mg/L respectively;p = 0.009) and fibrinogen (6.0 [5.3;6.7] and 5.2 [4.3;6.2] g/l respectively;p= 0.005)in patients having therapy including olokizumabwere significantly higher than in the control group. The levels of erythrocyte sedimentation rate, fibrinogen andferritin, D-dimer, detectedupon admission of patients to the hospital, didn'thave statistically significant differences. At discharge, the erythrocyte sedimentation rate in patients receiving olokizumab was statistically significantly lower (9.0 [5.5;14.5] and 13.0 [7.0;27.0] mm/h;p = 0.018). Conclusions. Using olokizumabin the treatment patientwithCOVID-19 pneumonia hasdemonstrateda positive effecton clinical and laboratory parameters (erythrocyte sedimentation rate, fibrinogen level) in patients with pronounced inflammatory changes and respiratory impairment. © 2022 Acta Biomedica Scientifica. All rights reserved.

Mallory-Weiss syndrome associated with new coronavirus infection COVID-19

The article presents a clinical case of the fatal Mallory-Weiss syndrome, which suddenly developed in an 86-year-old patient with a new coronavirus infection COVID-19, complicated by bilateral polysegmental pneumonia. The patient had no history of gastroesophageal reflux disease, gastric ulcer or duodenal ulcer. The level of D-dimer on admission was elevated, but the patient was prescribed a reduced dose of anticoagulants (heparin). Despite the initial positive dynamics of the condition, the patient had a wave-like course of COVID-19, followed by the development of Mallory-Weiss syndrome, extremely severe post-hemorrhagic anemia and multiple organ failure, which became the cause of death. © 2021 Global Media Tekhnologii. All Rights Reserved.