tetano
Editor, Senior Moderator
Immunol Lett
. 2020 Nov 5;S0165-2478(20)30405-3.
doi: 10.1016/j.imlet.2020.10.009. Online ahead of print.
Pulmonary vascular improvement in severe COVID-19 patients treated with tocilizumab
Lorenzo Salvati[SUP] 1 [/SUP], Mariaelena Occhipinti[SUP] 1 [/SUP], Leonardo Gori[SUP] 1 [/SUP], Luca Ciani[SUP] 1 [/SUP], Alessio Mazzoni[SUP] 1 [/SUP], Laura Maggi[SUP] 1 [/SUP], Manuela Capone[SUP] 1 [/SUP], Paola Parronchi[SUP] 2 [/SUP], Francesco Liotta[SUP] 2 [/SUP], Vittorio Miele[SUP] 3 [/SUP], Francesco Annunziato[SUP] 4 [/SUP], Federico Lavorini[SUP] 5 [/SUP], Lorenzo Cosmi[SUP] 6 [/SUP]
Affiliations
Abstract
As of October 2020 management of Coronavirus disease 2019 (COVID-19) is based on supportive care and off-label or compassionate-use therapies. On March 2020 tocilizumab - an anti-IL-6 receptor monoclonal antibody - was suggested as immunomodulatory treatment in severe COVID-19 because hyperinflammatory syndrome occurs in many patients similarly to the cytokine release syndrome that develops after CAR-T cell therapy. In our retrospective observational study, 20 severe COVID-19 patients were treated with tocilizumab in addition to standard-of-care therapy (SOC) and compared with 13 COVID-19 patients receiving only SOC. Clinical respiratory status, inflammatory markers and vascular radiologic score improved after one week from tocilizumab administration. On the contrary these parameters were stable or worsened in patients receiving only SOC. Despite major study limitations, improvement of alveolar-arterial oxygen gradient as well as vascular radiologic score after one week may account for improved pulmonary vascular perfusion and could explain the more rapid recovery of COVID-19 patients receiving tocilizumab compared to controls.
Keywords: IL-6; alveolar-arterial oxygen gradient; chest-X ray; severe COVID-19; tocilizumab; vascular score.
. 2020 Nov 5;S0165-2478(20)30405-3.
doi: 10.1016/j.imlet.2020.10.009. Online ahead of print.
Pulmonary vascular improvement in severe COVID-19 patients treated with tocilizumab
Lorenzo Salvati[SUP] 1 [/SUP], Mariaelena Occhipinti[SUP] 1 [/SUP], Leonardo Gori[SUP] 1 [/SUP], Luca Ciani[SUP] 1 [/SUP], Alessio Mazzoni[SUP] 1 [/SUP], Laura Maggi[SUP] 1 [/SUP], Manuela Capone[SUP] 1 [/SUP], Paola Parronchi[SUP] 2 [/SUP], Francesco Liotta[SUP] 2 [/SUP], Vittorio Miele[SUP] 3 [/SUP], Francesco Annunziato[SUP] 4 [/SUP], Federico Lavorini[SUP] 5 [/SUP], Lorenzo Cosmi[SUP] 6 [/SUP]
Affiliations
- PMID: 33161002
- DOI: 10.1016/j.imlet.2020.10.009
Abstract
As of October 2020 management of Coronavirus disease 2019 (COVID-19) is based on supportive care and off-label or compassionate-use therapies. On March 2020 tocilizumab - an anti-IL-6 receptor monoclonal antibody - was suggested as immunomodulatory treatment in severe COVID-19 because hyperinflammatory syndrome occurs in many patients similarly to the cytokine release syndrome that develops after CAR-T cell therapy. In our retrospective observational study, 20 severe COVID-19 patients were treated with tocilizumab in addition to standard-of-care therapy (SOC) and compared with 13 COVID-19 patients receiving only SOC. Clinical respiratory status, inflammatory markers and vascular radiologic score improved after one week from tocilizumab administration. On the contrary these parameters were stable or worsened in patients receiving only SOC. Despite major study limitations, improvement of alveolar-arterial oxygen gradient as well as vascular radiologic score after one week may account for improved pulmonary vascular perfusion and could explain the more rapid recovery of COVID-19 patients receiving tocilizumab compared to controls.
Keywords: IL-6; alveolar-arterial oxygen gradient; chest-X ray; severe COVID-19; tocilizumab; vascular score.