Recovery of COVID-19 acute respiratory distress syndrome with tocilizumab: successful outcome in two critically ill patients

Severe pneumonia and acute respiratory distress syndrome (ARDS) due to COVID-19 is a challenge for nowadays medical practice. Although there is no clarity in the principal mechanism of lung damage and ARDS development, it has been suggested that one of the main reasons of this pathology is the hyper...

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Bibliographic Details
Published in:Immunotherapy 2020-10, Vol.12 (15), p.1127-1132
Main Authors: Cala-García, Juan David, Sierra-Bretón, Juan David, Cavelier-Baiz, Jorge Eduardo, Faccini-Martínez, Álvaro A, Pérez-Díaz, Carlos Eduardo
Format: Article
Language:English
Subjects:
Antiviral agents
ARDS
Azithromycin
Blood
C-reactive protein
Case Report
Coronaviruses
COVID-19
Cytokine storm
cytokine storm syndrome
Dehydrogenases
Dyspnea
Fever
Hemoglobin
Hospitalization
Hydroxychloroquine
hyperinflammation
IL-6
Immune system
immunotherapy
Infections
Laboratories
Lopinavir
Monoclonal antibodies
Neutrophils
Patients
Pneumonia
Proteins
Respiratory distress syndrome
Ritonavir
SARS-CoV-2
Sepsis
Septic shock
Severe acute respiratory syndrome coronavirus 2
severe pneumonia
tocilizumab
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Summary:Severe pneumonia and acute respiratory distress syndrome (ARDS) due to COVID-19 is a challenge for nowadays medical practice. Although there is no clarity in the principal mechanism of lung damage and ARDS development, it has been suggested that one of the main reasons of this pathology is the hyperactivation of the immune system, better known as cytokine storm syndrome. Tocilizumab has been proposed to treat COVID-19 severe cases associated to ARDS. Here we present two successful cases of tocilizumab administration in two COVID-19 patients with prior administration of antiviral therapy (hydroxychloroquine, azithromycin, lopinavir and ritonavir) with adequate response and resolution of ARDS, septic shock and severe pneumonia within the first 72 h. This case supports the usage of tocilizumab as an effective therapy in COVID-19 associated cytokine storm syndrome. Further studies should be done in order to assess its effectiveness and security.
ISSN:1750-743X
1750-7448
DOI:10.2217/imt-2020-0154