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How to follow-up a patient who received tocilizumab in severe COVID-19: a case report.
Podlasin, Regina B; Kowalska, Justyna D; Pihowicz, Andrzej; Wojtycha-Kwasnica, Beata; Thompson, Magdalena; Dyda, Tomasz; Czeszko-Paprocka, Hanna; Horban, Andrzej.
  • Podlasin RB; IV-th Department, Hospital for Infectious Diseases, Warsaw, Poland.
  • Kowalska JD; Department of Adults' Infectious Diseases, Medical University of Warsaw, Warsaw, Poland. jdkowalska@gmail.com.
  • Pihowicz A; Intensive Care Unit, Hospital for Infectious Diseases in Warsaw, Warsaw, Poland.
  • Wojtycha-Kwasnica B; Department of Diagnostic Imaging, Hospital for Infectious Diseases in Warsaw, Warsaw, Poland.
  • Thompson M; IV-th Department, Hospital for Infectious Diseases, Warsaw, Poland.
  • Dyda T; Molecular Diagnostics Laboratory, Hospital for Infectious Diseases in Warsaw, Warsaw, Poland.
  • Czeszko-Paprocka H; Central Analytical Laboratory, Hospital for Infectious Diseases in Warsaw, Warsaw, Poland.
  • Horban A; Department of Adults' Infectious Diseases, Medical University of Warsaw, Warsaw, Poland.
Eur J Med Res ; 25(1): 37, 2020 Aug 27.
Artículo en Inglés | MEDLINE | ID: covidwho-733022
ABSTRACT

BACKGROUND:

COVID-19 is characterized by fast deterioration in the mechanism of cytokine storm. Therefore, treatment with immunomodulating agents should be initiated as soon as hyperinflammation is established. Evidence for the use of tocilizumab (TCZ) in COVID-19 is emerging, but the drug in this setting is used "off label" with limited data on both effectiveness and safety. Therefore, Hospital for Infectious Diseases in Warsaw established a Standard Operating Procedure (SOP) for the use of TCZ in severe COVID-19 cases. CASE PRESENTATION Here, we present a case of 27-year-old, otherwise healthy man, who was successfully treated with chloroquine, azithromycin, tocilizumab and a standard of care. Initially the magnitude of lung devastation, clinical deterioration and the need for mechanical ventilation suggested unfavorable prognosis. However, we observed complete regression in radiological changes and rapid clinical improvement. Irrespective of this, patient's serum interleukin 6 and aminotransferases remained elevated even after a month from treatment.

CONCLUSIONS:

An overlapping effect of hyperinflammation, hypoxic organ injury and drug-related toxicity warrants a long-term follow-up for COVID-19 survivors. In addition, residual IL-6 receptors blockage may mask new infections. A standardized approach to follow-up for COVID-19 survivors is urgently needed. Current and future research should also investigate the impact of experimental therapies on lung tissue healing and regeneration, as well as long-term treatment toxicities.
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Anticuerpos Monoclonales Humanizados Tipo de estudio: Reporte de caso / Estudio de cohorte / Estudio pronóstico Límite: Adulto / Humanos / Masculino País/Región como asunto: Europa Idioma: Inglés Revista: Eur J Med Res Asunto de la revista: Medicina Año: 2020 Tipo del documento: Artículo País de afiliación: S40001-020-00438-x

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Anticuerpos Monoclonales Humanizados Tipo de estudio: Reporte de caso / Estudio de cohorte / Estudio pronóstico Límite: Adulto / Humanos / Masculino País/Región como asunto: Europa Idioma: Inglés Revista: Eur J Med Res Asunto de la revista: Medicina Año: 2020 Tipo del documento: Artículo País de afiliación: S40001-020-00438-x