Notes From the Field: The Combined Effects of Tocilizumab and Remdesivir in a Patient With Severe COVID-19 and Cytokine Release Syndrome.
Sabahat AliSundas KhalidMaham AfridiSamar AkhtarYousef Saleh KhaderHashaam AkhtarPublished in: JMIR public health and surveillance (2021)
SARS-CoV-2 is known to cause severe bilateral pneumonia and acute respiratory distress syndrome or COVID-19 in patients, which can be debilitating and even fatal. With no drugs or vaccines available yet, a wide range of treatment regimens used are being repurposed. The need of the hour is to analyze various currently available regimens and devise a treatment plan that is most effective for COVID-19. Here we describe the case of a 68-year-old man with hypertension and diabetes, exhibiting symptoms of cough and shortness of breath, who presented at the emergency department of our hospital. Chest computed tomography revealed bilateral ground glass opacities that were indicative of COVID-19, and a computed tomography score of 24 was indicative of severe pulmonary pneumonia. He tested positive for COVID-19. His treatment regimen included the use of convalescent plasma, oxygen therapy, steroids, high-dose antibiotics, broad-spectrum antiviral remdesivir, and anti-interleukin-6 monoclonal antibody (Tocilizumab) at various stages of the disease. Oxygen supplementation was required at the time of admission. The patient initially developed a cytokine release storm, and oxygen supplementation was initiated to manage his condition. Supportive care and multiple treatment regimens were used to successfully recover the patient's health. With a rapid increase in number of confirmed cases worldwide, COVID-19 has become a major challenge to our health care system. With no available vaccines currently, the establishment of a combination of therapeutic drugs that effectively reduce disease progression is of utmost importance.
Keyphrases
- sars cov
- coronavirus disease
- emergency department
- computed tomography
- case report
- acute respiratory distress syndrome
- healthcare
- high dose
- rheumatoid arthritis
- respiratory syndrome coronavirus
- type diabetes
- magnetic resonance imaging
- public health
- palliative care
- pulmonary hypertension
- stem cells
- monoclonal antibody
- early onset
- combination therapy
- adipose tissue
- extracorporeal membrane oxygenation
- physical activity
- end stage renal disease
- magnetic resonance
- stem cell transplantation
- chronic pain
- depressive symptoms
- single cell
- patient reported outcomes
- chronic kidney disease
- pain management
- electronic health record
- disease activity
- affordable care act