tetano
Editor, Senior Moderator
Int J Infect Dis
. 2020 Jun 1;S1201-9712(20)30425-2.
doi: 10.1016/j.ijid.2020.05.118. Online ahead of print.
Combination of Thrombolytic and Immunosuppressive Therapy for Coronavirus Disease 2019: A Case Report
Panagiotis Papamichalis[SUP] 1 [/SUP], Antonios Papadogoulas[SUP] 2 [/SUP], Periklis Katsiafylloudis[SUP] 2 [/SUP], Apostolia-Lemonia Skoura[SUP] 2 [/SUP], Michail Papamichalis[SUP] 3 [/SUP], Evangelia Neou[SUP] 2 [/SUP], Dimitrios Papadopoulos[SUP] 2 [/SUP], Spyridon Karagiannis[SUP] 2 [/SUP], Tilemachos Zafeiridis[SUP] 2 [/SUP], Dimitris Babalis[SUP] 4 [/SUP], Apostolos Komnos[SUP] 2 [/SUP]
Affiliations
Abstract
In a proportion of patients Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes a multi-systematic syndrome characterized by hyperinflammation, Acute Respiratory Distress Syndrome (ARDS) and hypercoagulability. A 68-year-old man with Coronavirus Disease 2019 (COVID-19) presented in our Intensive Care Unit (ICU) with respiratory failure, Cytokine Release Syndrome (CRS) and skin ischemia - microthrombosis. Specific coagulation and inflammatory markers (D-dimer, ferritin and C-reactive protein) along with the clinical picture triggered the trial of recombinant tissue plasminogen activator (rt-PA) and Tocilizumab. This was followed by resolution of skin ischemia and CRS while respiratory parameters improved. No major complications associated with rt-PA or Tocilizumab occurred. Combination of rt-PA with targeted anti-inflammatory treatment could be a new therapeutic option for patients with COVID-19, ARDS, hyperinflammation and increased blood viscosity.
Keywords: Acute Respiratory Distress Syndrome; Coronavirus Disease 2019; D-dimer; Recombinant Tissue Plasminogen Activator; Tocilizumab.
. 2020 Jun 1;S1201-9712(20)30425-2.
doi: 10.1016/j.ijid.2020.05.118. Online ahead of print.
Combination of Thrombolytic and Immunosuppressive Therapy for Coronavirus Disease 2019: A Case Report
Panagiotis Papamichalis[SUP] 1 [/SUP], Antonios Papadogoulas[SUP] 2 [/SUP], Periklis Katsiafylloudis[SUP] 2 [/SUP], Apostolia-Lemonia Skoura[SUP] 2 [/SUP], Michail Papamichalis[SUP] 3 [/SUP], Evangelia Neou[SUP] 2 [/SUP], Dimitrios Papadopoulos[SUP] 2 [/SUP], Spyridon Karagiannis[SUP] 2 [/SUP], Tilemachos Zafeiridis[SUP] 2 [/SUP], Dimitris Babalis[SUP] 4 [/SUP], Apostolos Komnos[SUP] 2 [/SUP]
Affiliations
- PMID: 32497796
- DOI: 10.1016/j.ijid.2020.05.118
Abstract
In a proportion of patients Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes a multi-systematic syndrome characterized by hyperinflammation, Acute Respiratory Distress Syndrome (ARDS) and hypercoagulability. A 68-year-old man with Coronavirus Disease 2019 (COVID-19) presented in our Intensive Care Unit (ICU) with respiratory failure, Cytokine Release Syndrome (CRS) and skin ischemia - microthrombosis. Specific coagulation and inflammatory markers (D-dimer, ferritin and C-reactive protein) along with the clinical picture triggered the trial of recombinant tissue plasminogen activator (rt-PA) and Tocilizumab. This was followed by resolution of skin ischemia and CRS while respiratory parameters improved. No major complications associated with rt-PA or Tocilizumab occurred. Combination of rt-PA with targeted anti-inflammatory treatment could be a new therapeutic option for patients with COVID-19, ARDS, hyperinflammation and increased blood viscosity.
Keywords: Acute Respiratory Distress Syndrome; Coronavirus Disease 2019; D-dimer; Recombinant Tissue Plasminogen Activator; Tocilizumab.