[Fatal course of COVID-19 despite IL-6 receptor blockade in cytokine storm : Perimyocarditis and coagulopathy after administration of tocilizumab]. / Fataler COVID-19-Verlauf trotz IL6Rezeptor-Blockade im Zytokinsturm : Perimyokarditis und Koagulopathie nach Tocilizumabgabe.
Anaesthesist
; 70(2): 121-126, 2021 Feb.
Artículo
en Alemán
| MEDLINE | ID: covidwho-1453674
ABSTRACT
A 59-year-old male patient was admitted to hospital diagnosed with moderate pneumonia associated with COVID-19. Upfront treatment with hydroxychloroquine and azithromycin was started. Due to a clinical deterioration (ARDS, circulatory shock) and greatly increased inflammation markers 6 days after admission, a cytokine storm was suspected and off-label treatment with the IL6 receptor antagonist tocilizumab was initiated. Subsequently there was a dramatic rise of Ddimers indicating pulmonary intravascular coagulopathy and respiratory insufficiency worsened. After a second dose of tocilizumab was administered severe perimyocarditis with cardiac arrhythmia, hemodynamic instability and ST elevation occurred. Shortly afterwards the patient died due to multiorgan failure. From our experience, exacerbation of COVID-19 following treatment with tocilizumab cannot be ruled out. Randomized controlled studies are necessary to further investigate the efficacy, safety and patient selection criteria for tocilizumab treatment in COVID-19.
Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Antivirales
/
Trastornos de la Coagulación Sanguínea
/
Receptores de Interleucina-6
/
Anticuerpos Monoclonales Humanizados
/
Síndrome de Liberación de Citoquinas
/
Tratamiento Farmacológico de COVID-19
/
Miocarditis
Tipo de estudio:
Reporte de caso
/
Estudio experimental
/
Estudio pronóstico
/
Ensayo controlado aleatorizado
Tópicos:
Vacunas
Límite:
Humanos
/
Masculino
/
Middle aged
Idioma:
Alemán
Revista:
Anaesthesist
Año:
2021
Tipo del documento:
Artículo
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