Tocilizumab in Severe COVID-19 Pneumonia and Concomitant Cytokine Release Syndrome

  • Tom van Kraaij Department of Pulmonology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
  • Rémy Mostard Department of Pulmonology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
  • Sofia Ramiro Department of Rheumatology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
  • Cesar Magro Checa Department of Rheumatology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
  • Christel van Dongen Department of Rheumatology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
  • Eric HJ van Haren Department of Pulmonology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
  • Jacqueline Buijs Department of Internal Medicine, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
  • Robert Landewé Department of Rheumatology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands

Keywords

COVID-19, cytokine release syndrome, tocilizumab

Abstract

Younger patients with COVID-19 may experience an exaggerated immune response to SARS-CoV-2 infection and develop cytokine release syndrome (CRS), which may be life threatening. There is no proven antiviral therapy for COVID-19 so far, but profound immunosuppression has recently been suggested as a treatment for COVID-19-associated CRS. We present a case of life-threatening CRS caused by COVID-19 infection with a favourable response to immunosuppressive therapy with tocilizumab (TCZ). The rapid clinical and biochemical improvement following TCZ administration suggests that treatment with immunotherapy can be life-saving in selected patients with COVID-19-induced CRS.

VIEW THE ENTIRE ARTICLE

References

  • Ruan Q, Yang K, Wang W, et al. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med 2020 Mar 3. doi: 10.1007/s00134-020-05991-x [Epub ahead of print].

  • Apoorva Mandavilli. The coronavirus patients betrayed by their own immune systems. The New York Times. 1st April 2020.

  • Mehta PM, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020;395(10229):1033–1034.

  • Maude SL, Laetsch TW, Buechner J, et al. Tisagenlecleucel in children and young adults with B-cell lymphoblastic leukemia. N Engl J Med 2018;378(5):439–448.

  • Le RQ, Li L, Yuan W, et al. FDA approval summary: tocilizumab for treatment of chimeric antigen receptor T cell-induced severe or life-threatening cytokine release syndrome. Oncologist 2018;23(8):943–947.
  • Published: 2020-04-22

    Issue: Vol 7 No 5 (view)

    Section: Articles

    How to cite:
    1.
    van Kraaij T, Mostard R, Ramiro S, Magro Checa C, van Dongen C, van Haren EH, Buijs J, Landewé R. Tocilizumab in Severe COVID-19 Pneumonia and Concomitant Cytokine Release Syndrome. EJCRIM [Internet]. 2020Apr.22 [cited 2020Oct.24];7(5). Available from: https://www.ejcrim.com/index.php/EJCRIM/article/view/1675

    Most read articles by the same author(s)