This case series reviews four critically ill patients infected with severe acute respiratory syndrome coronavirus 2 (SARS – CoV – 2) [coronavirus disease 2019 (COVID-19)] suffering from pneumatosis intestinalis (PI) during their hospital admission. All patients received the biological agent tocilizumab (TCZ), an interleukin (IL)-6 antagonist, as an experimental treatment for COVID-19 before developing PI. COVID-19 and TCZ have been independently linked to PI risk, yet the cause of this relationship is unknown and under speculation. PI is a rare condition, defined as the presence of gas in the intestinal wall, and although its pathogenesis is poorly understood, intestinal ischemia is one of its causative agents. Based on COVID-19’s association with vasculopathic and ischemic insults, and IL-6’s protective role in intestinal epithelial ischemia–reperfusion injury, an adverse synergistic association of COVID-19 and TCZ can be proposed in the setting of PI. To our knowledge, this is the first published, single center, case series of pneumatosis intestinalis in COVID-19 patients who received tocilizumab therapy.
【저자키워드】 COVID-19, SARS-CoV-2, Tocilizumab, IL-6 inhibitor, mesenteric ischemia, pneumatosis intestinalis, ischemia-reperfusion injury, molecular targeted therapy, 【초록키워드】 coronavirus, Pathogenesis, IL-6, knowledge, risk, Patient, CoV, Hospital admission, disease, epithelial, association, Ischemia, Injury, COVID-19 patient, Critically ill patient, acute respiratory syndrome, protective role, single center, tocilizumab therapy, synergistic, intestinal, intestinal wall, defined, case sery, TCZ, treatment for COVID-19, 【제목키워드】 New York, center, setting, pneumatosis, Sery,