Abstract
As of 28 October 2020, there are over 44 000 000 confirmed COVID-19 infections and over 1 000 000 deaths worldwide, including 945 367 infections and 45 765 deaths in the UK. Acute respiratory distress syndrome occurs in 50% of patients with secondary haemophagocytic lymphohistiocytosis, a hyperinflammatory syndrome characterised by a surge of cytokines, including interleukin 6 (IL-6). Here we describe the case of the first patient with severe COVID-19 pneumonia successfully treated with tocilizumab, a humanised monoclonal antibody against the IL-6 receptor, in the UK. Early treatment (after 7-10 days from the onset of symptoms) with tocilizumab could (1) reduce the risk of requiring non-invasive or invasive ventilation; (2) offer a chance of survival to people who are not fit for escalation or have refused to be ventilated; and (3) potentially increase the chance of survival in some patients who are already ventilated but fail to improve with supportive treatment.
Keywords: global health; infections; medical management; pneumonia (infectious disease); therapeutic indications.
【저자키워드】 global health, infections, medical management, pneumonia (infectious disease), therapeutic indications., 【초록키워드】 Treatment, Severe COVID-19 pneumonia, Cytokines, Tocilizumab, Pneumonia, IL-6, monoclonal antibody, Infection, risk, survival, Hyperinflammatory syndrome, Patient, death, Escalation, distress, IL-6 receptor, secondary haemophagocytic lymphohistiocytosis, Non-invasive, Ventilated, Supportive treatment, syndrome, Confirmed COVID-19 infection, offer, invasive, therapeutic indications, IMPROVE, treated, occur, reduce, onset of symptoms, 【제목키워드】 Treatment, Severe COVID-19 pneumonia, Tocilizumab, Hyperinflammatory syndrome,