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Post-transplant patients with COVID-19 associated acute respiratory distress syndrome, a role for Tociluzumab: A case series.
Respir Med Case Rep. 2021; 32:101319.RM

Abstract

COVID-19 is the disease caused by SARS-CoV-2 that portends both a relatively high mortality rate as well as high rate of intensive care admission amongst all age groups; however effective therapy remains poorly characterized. Post-transplant patients are especially high risk and underrepresented in the literature. In these patients, cytokine release may play a significant role in the development of acute respiratory distress syndrome, raising the hypothesis that interleukin-6 inhibitors such as tocilizumab may be of benefit. Here, we describe two high-risk post-transplant patients who were treated with single-dose tocilizumab after intubation for moderate acute respiratory distress syndrome secondary to confirmed COVID-19 infection. Both patients recovered rapidly and were successfully extubated and discharged from the hospital without need for supplemental oxygen shortly thereafter, and their clinical improvement correlated with response in interleukin-6 levels. Tocilizumab appears to hold promise for critically ill COVID-19 patients who require mechanical ventilation when given shortly after intubation.

Authors+Show Affiliations

Division of Internal Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States.Division of Internal Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States.Division of Internal Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States.Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

33318918

Citation

Ladna, M, et al. "Post-transplant Patients With COVID-19 Associated Acute Respiratory Distress Syndrome, a Role for Tociluzumab: a Case Series." Respiratory Medicine Case Reports, vol. 32, 2021, p. 101319.
Ladna M, Villanueva FL, Maharrey PB, et al. Post-transplant patients with COVID-19 associated acute respiratory distress syndrome, a role for Tociluzumab: A case series. Respir Med Case Rep. 2021;32:101319.
Ladna, M., Villanueva, F. L., Maharrey, P. B., & Lascano, J. (2021). Post-transplant patients with COVID-19 associated acute respiratory distress syndrome, a role for Tociluzumab: A case series. Respiratory Medicine Case Reports, 32, 101319. https://doi.org/10.1016/j.rmcr.2020.101319
Ladna M, et al. Post-transplant Patients With COVID-19 Associated Acute Respiratory Distress Syndrome, a Role for Tociluzumab: a Case Series. Respir Med Case Rep. 2021;32:101319. PubMed PMID: 33318918.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-transplant patients with COVID-19 associated acute respiratory distress syndrome, a role for Tociluzumab: A case series. AU - Ladna,M, AU - Villanueva,F L, AU - Maharrey,P B, AU - Lascano,J, Y1 - 2020/12/09/ PY - 2020/08/06/received PY - 2020/12/03/revised PY - 2020/12/07/accepted PY - 2020/12/16/pubmed PY - 2020/12/16/medline PY - 2020/12/15/entrez KW - Acute respiratory distress syndrome KW - COVID-19 KW - Critical care KW - LIST, ARDS KW - Respiratory failure KW - Tocilizumab KW - acute respiratory distress syndrome, COVID-19 KW - computerized tomography, IL KW - coronavirus disease of 2019, CT KW - interleukin, CAR-T cell: chimeric antigen receptor T-cell SP - 101319 EP - 101319 JF - Respiratory medicine case reports JO - Respir Med Case Rep VL - 32 N2 - COVID-19 is the disease caused by SARS-CoV-2 that portends both a relatively high mortality rate as well as high rate of intensive care admission amongst all age groups; however effective therapy remains poorly characterized. Post-transplant patients are especially high risk and underrepresented in the literature. In these patients, cytokine release may play a significant role in the development of acute respiratory distress syndrome, raising the hypothesis that interleukin-6 inhibitors such as tocilizumab may be of benefit. Here, we describe two high-risk post-transplant patients who were treated with single-dose tocilizumab after intubation for moderate acute respiratory distress syndrome secondary to confirmed COVID-19 infection. Both patients recovered rapidly and were successfully extubated and discharged from the hospital without need for supplemental oxygen shortly thereafter, and their clinical improvement correlated with response in interleukin-6 levels. Tocilizumab appears to hold promise for critically ill COVID-19 patients who require mechanical ventilation when given shortly after intubation. SN - 2213-0071 UR - https://www.unboundmedicine.com/medline/citation/33318918/Post_transplant_patients_with_COVID_19_associated_acute_respiratory_distress_syndrome_a_role_for_Tociluzumab:_A_case_series_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-0071(20)30533-5 DB - PRIME DP - Unbound Medicine ER -
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