Abstract
An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2, initially in December 2019 at Wuhan, China, subsequently spread around the world. We describe a case series of COVID-19 patients treated at our academic medical center with focus on cytokine storm and potential therapeutic role of tocilizumab. A 59-year-old female admitted for shortness of breath (SOB), productive cough, fever, and nausea in the setting of COVID-19 pneumonia. Oxygen saturation was 81% necessitating supplemental oxygen. She was transferred to intensive care unit (ICU) for worsening hypoxia; intubated and received tocilizumab following which her oxygen requirements improved. A 52-year-old female admitted from an outside hospital with SOB, intubated for worsening hypoxia, in the setting of COVID-19 pneumonia. She received tocilizumab 400 mg intravenous for 2 doses on ICU admission, with clinical improvement. A 56-year-old female hospitalized with worsening SOB, fever, and cough for 8 days saturating 88% on room air in the setting of COVID-19 pneumonia. Worsening hypoxia necessitated high flow nasal cannula. She was transferred to the ICU where she received 2 doses of tocilizumab 400 mg intravenous. She did not require intubation and was transitioned to nasal cannula. A hyperinflammatory syndrome may cause a life-threatening acute respiratory distress syndrome in patients with COVID-19 pneumonia. Tocilizumab is the first marketed interleukin-6 blocking antibody, and through targeting interleukin-6 receptors likely has a role in treating cytokine storm. We noted clinical improvement of patients treated with tocilizumab.
Keywords: ARDS; COVID-19; coronavirus; cytokine storm; tocilizumab.
【저자키워드】 COVID-19, ARDS, Cytokine storm, coronavirus, Tocilizumab, 【초록키워드】 coronavirus disease, Hospitalized, intensive care, hypoxia, Tocilizumab, Pneumonia, antibody, hospital, interleukin-6, intubation, nasal, cytokine, cough, ICU, Spread, Hyperinflammatory syndrome, outbreak, Fever, therapeutic, female, ICU admission, Clinical improvement, interleukin-6 receptor, acute respiratory distress, Coronavirus-2, dose, COVID-19 patient, intravenous, Shortness of breath, supplemental oxygen, acute respiratory syndrome, Intubated, worsening, syndrome, life-threatening, nausea, Oxygen requirement, Wuhan, China, caused, case sery, treated, patients treated, patients with COVID-19, transferred, transitioned, 【제목키워드】 respiratory, level 1, center, storm, Sery,