Thromboinflammation response to tocilizumab in COVID‐19. Issue 8 (18th October 2020)

• Record Type: Journal Article
• Authors: Gergi, Mansour; Cushman, Mary; Littenberg, Benjamin; Budd, Ralph C.
• Is Part Of: Research and practice in thrombosis and haemostasis. Volume 4:Issue 8(2020)
• Page Start: 1262
• Page End: 1268
• Publication Date: 2020-10-18
• Subjects: COVID‐19 -- COVID‐19 coagulopathy -- interleukin‐6 -- thromboinflammation -- tocilizumab; Thrombosis -- Periodicals; Hemostasis -- Periodicals; 616.135005
• DOI: 10.1002/rth2.12436
• Languages: English
• ISSNs: 2475-0379

Abstract

Abstract: Background: Coronavirus disease‐19 (COVID‐19) spans a wide spectrum of illness. Severe cases of COVID‐19 can manifest inflammation in organs other than the lung, in tissues not known to support viral replication, and also in a hypercoagulable state. These observations have suggested that severe acute respiratory syndrome coronavirus 2 can provoke a hyperimmune response in some cases that could lead to secondary organ damage. Methods: With evidence of elevated levels of interleukin‐6 (IL‐6) in patients with severe COVID‐19, we conducted a small pilot off‐label compassionate care study of the IL‐6 receptor inhibitor tocilizumab in patients with severe COVID‐19. Results: A single infusion of tocilizumab in patients with severe COVID‐19 manifested rapid declines in C‐reactive protein and d ‐dimer and gradual rises in lymphocyte and platelet counts. Conclusions: These findings suggest both pathophysiological mechanisms and clinical benefit that might be seen with IL‐6 inhibition in severe COVID‐19.