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Tocilizumab for the Treatment of COVID-19-Induced Cytokine Storm and Acute Respiratory Distress Syndrome: A Case Series From a Rural Level 1 Trauma Center in Western Pennsylvania.
Suresh, Krithika; Figart, Michael; Formeck, Samantha; Mehmood, Talha; Abdel Salam, Mahmoud; Bassilly, David.
  • Suresh K; Conemaugh Memorial Medical Center, Johnstown, PA, USA.
  • Figart M; Conemaugh Memorial Medical Center, Johnstown, PA, USA.
  • Formeck S; Conemaugh Memorial Medical Center, Johnstown, PA, USA.
  • Mehmood T; Conemaugh Memorial Medical Center, Johnstown, PA, USA.
  • Abdel Salam M; Conemaugh Memorial Medical Center, Johnstown, PA, USA.
  • Bassilly D; Conemaugh Memorial Medical Center, Johnstown, PA, USA.
J Investig Med High Impact Case Rep ; 9: 23247096211019557, 2021.
Article in English | MEDLINE | ID: covidwho-1262488
ABSTRACT
An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2, initially in December 2019 at Wuhan, China, subsequently spread around the world. We describe a case series of COVID-19 patients treated at our academic medical center with focus on cytokine storm and potential therapeutic role of tocilizumab. A 59-year-old female admitted for shortness of breath (SOB), productive cough, fever, and nausea in the setting of COVID-19 pneumonia. Oxygen saturation was 81% necessitating supplemental oxygen. She was transferred to intensive care unit (ICU) for worsening hypoxia; intubated and received tocilizumab following which her oxygen requirements improved. A 52-year-old female admitted from an outside hospital with SOB, intubated for worsening hypoxia, in the setting of COVID-19 pneumonia. She received tocilizumab 400 mg intravenous for 2 doses on ICU admission, with clinical improvement. A 56-year-old female hospitalized with worsening SOB, fever, and cough for 8 days saturating 88% on room air in the setting of COVID-19 pneumonia. Worsening hypoxia necessitated high flow nasal cannula. She was transferred to the ICU where she received 2 doses of tocilizumab 400 mg intravenous. She did not require intubation and was transitioned to nasal cannula. A hyperinflammatory syndrome may cause a life-threatening acute respiratory distress syndrome in patients with COVID-19 pneumonia. Tocilizumab is the first marketed interleukin-6 blocking antibody, and through targeting interleukin-6 receptors likely has a role in treating cytokine storm. We noted clinical improvement of patients treated with tocilizumab.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Receptors, Interleukin-6 / Antibodies, Monoclonal, Humanized / Cytokine Release Syndrome / COVID-19 Type of study: Case report / Prognostic study Topics: Long Covid Limits: Female / Humans / Middle aged Country/Region as subject: North America Language: English Journal: J Investig Med High Impact Case Rep Year: 2021 Document Type: Article Affiliation country: 23247096211019557

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Receptors, Interleukin-6 / Antibodies, Monoclonal, Humanized / Cytokine Release Syndrome / COVID-19 Type of study: Case report / Prognostic study Topics: Long Covid Limits: Female / Humans / Middle aged Country/Region as subject: North America Language: English Journal: J Investig Med High Impact Case Rep Year: 2021 Document Type: Article Affiliation country: 23247096211019557