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1.
Immun Inflamm Dis ; 10(3): e587, 2022 03.
Article in English | MEDLINE | ID: covidwho-1625924

ABSTRACT

BACKGROUND: Tocilizumab was studied to reduce cytokine syndrome in patients with severe COVID-19 pneumonia in solid organ transplant (SOT) recipients with conflicting results. We aim to study the early use of tocilizumab in SOT with COVID-19 pneumonia on low flow oxygen. METHODS: This is a retrospective cohort study that was conducted in two transplant centers in Saudi Arabia among 46 SOT with COVID-19 comparing 21 patients who received tocilizumab to 25 patients who received standard of care. Their clinical characteristics and outcomes were described. RESULTS: Compared to patients who received standard of care, patients in the tocilizumab group were older (60.2 ± 12.8 vs. 48.6 ± 12.3, p = .003), had higher ferritin (862.1 ± 919.1 vs. 414 ± 447.3, p = .025) and C-reactive protein (CRP) (85 ± 83.1 vs. 42.9 ± 57.3, p = .012). More patients in the tocilizumab group required high flow oxygen (38.1% vs. 8.0%, p = .028) compared to patients on standard of care. There were no differences in mortality or mechanical ventilation requirement. Hospital stay was significantly shorter in the tocilizumab group than the standard of care group (9.6 ± 7.4 vs. 20.7 ± 11.7, p < .001). CONCLUSIONS: Early use of tocilizumab in SOT was associated with a shorter hospital stay. There was no difference in mortality rate and the requirement for mechanical ventilation in both groups.


Subject(s)
COVID-19 , Organ Transplantation , Antibodies, Monoclonal, Humanized , COVID-19/drug therapy , Humans , Retrospective Studies , SARS-CoV-2 , Saudi Arabia/epidemiology
2.
Rev Esp Geriatr Gerontol ; 55(5): 286-288, 2020.
Article in Spanish | MEDLINE | ID: covidwho-1386531

ABSTRACT

INTRODUCTION: Cytokine storm syndrome (CTS) is a serious complication of patients with SARS-CoV-2 infection. Treatment and evolution in octogenarians are not well defined. Our objective is to describe its clinical characteristics, the treatments and its clinical evolution. PATIENTS AND METHOD: Retrospective observational study of consecutive patients admitted in the period between March 23 and April 12, 2020 with confirmed SARS-CoV-2 infection, with pneumonia by radiological study or chest tomography, whith STC criteria and who received treatment. We classified patients as those who received only glucocorticoid (GC) pulses, or GC and tocilizumab pulses. We determined serum levels of ferritin, CRP and D-dimers. The final variable was survival. RESULTS: 21 patients, (80-88 years). The mean ferritin was 1056 microg/L (317-3,553), CRP 115.8mg/dL (22-306) and D-dimers 2.9m/L (0.45-17.5). All patients received GC pulses and in 2 cases simultaneously tocilizumab. The mean follow-up time was 13.7 days (8-21). The overall mortality was 38.1% (8/21 patients). The 2 patients who received tocilizumab died. The deceased had significantly higher levels of ferritin (1,254 vs. 925microg/L; P=.045) and CRP (197.6 vs. 76mg / dL; P=.007). At the end of the follow-up, a decrease in the biochemical parameters was observed with ferritin of 727microg/L, CRP of 27mg/dl and D-dimers of 1.18mg/L. In 13/21 patients (61.9%), the CTS was controlled without the need to add other treatments. CONCLUSIONS: STC mortality from SARS-CoV-2 is high despite treatment. A greater inflammatory response was associated with a higher mortality. Although it seems that the early use of GC pulses could control it, and the use of other treatments such as tocilizumab shouldo be, with the study design and its limitations, this conclusion cannot be stablished.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Coronavirus Infections/complications , Coronavirus Infections/immunology , Cytokines/immunology , Glucocorticoids/therapeutic use , Immunoproliferative Disorders/drug therapy , Immunoproliferative Disorders/virology , Pneumonia, Viral/complications , Pneumonia, Viral/immunology , Aged, 80 and over , COVID-19 , Female , Humans , Male , Pandemics , Retrospective Studies , Syndrome
3.
Front Neurol ; 12: 660087, 2021.
Article in English | MEDLINE | ID: covidwho-1207703

ABSTRACT

The current pandemic caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a public health emergency. To date, March 1, 2021, coronavirus disease 2019 (COVID-19) has caused about 114 million accumulated cases and 2.53 million deaths worldwide. Previous pieces of evidence suggest that SARS-CoV-2 may affect the central nervous system (CNS) and cause neurological symptoms in COVID-19 patients. It is also known that angiotensin-converting enzyme-2 (ACE2), the primary receptor for SARS-CoV-2 infection, is expressed in different brain areas and cell types. Thus, it is hypothesized that infection by this virus could generate or exacerbate neuropathological alterations. However, the molecular mechanisms that link COVID-19 disease and nerve damage are unclear. In this review, we describe the routes of SARS-CoV-2 invasion into the central nervous system. We also analyze the neuropathologic mechanisms underlying this viral infection, and their potential relationship with the neurological manifestations described in patients with COVID-19, and the appearance or exacerbation of some neurodegenerative diseases.

4.
Curr Pharm Des ; 27(33): 3551-3565, 2021.
Article in English | MEDLINE | ID: covidwho-1024454

ABSTRACT

Coronavirus was first discovered during the year 1930 and since then, various coronaviruses like HKU1, MERS-CoV , NL63 and SARS-CoV-2 have been found to infect humans. The COVID-19 pandemic caused by SARS-CoV-2 is spreading at an alarming rate, thereby creating a health emergency around the world. SARS-CoV2 is reported to be originated from a wet animal market of Wuhan, China. Since then, the world is searching for effective ways to manage and treat the COVID-19 infection. The infections have already multiplied with several folds compared to the number of persons infected by Middle East Respiratory Syndrome Coronavirus and Severe Acute Respiratory Syndrome. In order to fill the gap of knowledge about this virus, several pieces of evidence are required to control it so more lives could be saved. The present review is based on the publicly available literature in order to explore the knowledge regarding epidemiology, virology, diagnosis, clinical features, pharmacological and therapeutic ways to treat the novel coronavirus. This can be helpful in offering novel insights and potential therapeutics for fighting this disease.


Subject(s)
COVID-19 , Middle East Respiratory Syndrome Coronavirus , Animals , Humans , Pandemics , RNA, Viral , SARS-CoV-2
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