A retrospective study evaluating efficacy and safety of compassionate use of tocilizumab in 13 patients with severe-to-critically ill COVID-19: analysis of well-responding cases and rapidly-worsening cases after tocilizumab administration

We administered tocilizumab into 13 severe-to-critically ill patients with coronavirus disease 2019 (COVID-19) for compassionate use in combination with potential anti-viral agents in those who required an oxygen supply and showed increased laboratory inflammatory markers such as C-reactive protein (CRP) and ferritin. One injection of tocilizumab led to rapid improvements in clinical features, inflammatory findings, and oxygen supply in seven patients with severe COVID-19 and substantial amelioration in two patients who were critically ill, whereas four patients, who exhibited rapidly worsened respiratory function, required artificial ventilatory support even after tocilizumab treatment. Three of these four patients ultimately recovered from deterioration after methylprednisolone treatment. Administration of tocilizumab did not affect viral elimination nor IgG production specific for the virus. Compared with well-responding patients, rapidly-worsened patients showed a significantly higher ratio of ferritin vs. CRP. These findings suggest that tocilizumab has beneficial effects in severe-to-critically ill patients with COVID-19; however, in some cases, addition of methylprednisolone is required for disease rescue.

Immune Efficacy and Safety of Fucoidan Extracted from Gagome Kombu <i>(Kjellmaniella crassifolia)</i> in Healthy Japanese Subjects / 日本補完代替医療学会誌

Objective: We previously reported the immune-enhancing behavior of fucoidan, a sulfated polysaccharide extracted from Gagome kombu (GKF), both in vitro and in animal studies. In the present study, we evaluated the immune efficacy and safety of GKF in healthy Japanese adults.Methods: In this randomized, double blind, placebo-controlled study, 30 subjects who ingested GKF (200 mg/day) or placebo for 4 weeks were enrolled. For evaluation of efficacy, phytohemagglutinin-stimulated cytokine production in whole blood cells was measured. For evaluation of safety, blood chemistry analysis, hematological analysis, and urinalysis were conducted.Results: Almost all cytokine production decreased in samples from the placebo group during the test period. Ingestion of GKF for 4 weeks significantly suppressed the decrease in production of the T helper 1 (Th1)-type cytokines interferon-γ and interleukin-12 as well as the Th1:Th2 ratio. There were no adverse clinical changes in blood analysis and urinary analysis, and no serious symptom was observed.Conclusion: These results indicate that GKF is a useful and safe food ingredient to support immune function.