Clinical efficacy of tocilizumab treatment in severe and critical COVID-19 patients

作     者：Jia Zeng Ming-Hui Xie Jing Yang Sheng-Wu Chao Er-Li Xu 

作者机构：Department of Aviation DiseaseNaval Medical Center of PLAShanghai 200052China No.1 Department of InfectionOptical Valley Campus of Hubei Maternal and Child Health Care HospitalWuhan 430073Hubei ProvinceChina Department of Interventional TherapyFirst Affiliated Hospitalthe Second Military Medical UniversityShanghai 200433China Department of NephrologyNaval Medical Center of PLAShanghai 200052China Department of Cardiovascular MedicineNaval Medical Center of PLAShanghai 200052China 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2020年第8卷第17期

页      面：3763-3773页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：COVID-19 Cytokine storm Tocilizumab Interleukin-6 

摘      要：BACKGROUND The main pathophysiological basis of coronavirus disease 2019(COVID-19)causing respiratory failure is a cytokine storm and interleukin-6(IL-6)is an important component of the COVID-19 cytokine *** a specific antagonist of IL-6,tocilizumab may block the cytokine storm of *** Diagnosis and Treatment Guidelines of New Coronavirus Pneumonia(7 th Edition)includes tocilizumab as a recommended drug for immunotherapy in severe and critical COVID-19 ***,the specific clinical efficacy of tocilizumab in the treatment of COVID-19 patients is worth *** To determine the clinical efficacy of tocilizumab in inhibiting the cytokine storm in *** In total,19 severe and critical COVID-19 patients were enrolled in this study,and were treated with tocilizumab in Optical Valley Campus of Hubei Maternal and Child Health Care Hospital from February 20 to March 31,*** imaging manifestations and clinical data before and after treatment were analyzed retrospectively,including routine peripheral venous blood tests,routine blood biochemical tests,coagulation test,C-reactive protein(CRP),IL-6,and arterial blood gas *** Of the 19 patients in this group,13(68.4%)had significantly improved symptoms of COVID-19(5 patients were discharged directly and 8 patients were transferred after improvement)following *** case was invalid,1 case was exacerbated,and 4 deaths(21.1%)were observed(all critical cases).The lymphocyte count,CRP,lactic acid,oxygenation index,fibrinogen(FIB)and IL-6 levels were significantly different in the improved *** Tocilizumab treatment is effective against IL-6 in COVID-19 patients,but it does not completely inhibit the inflammation and cytokine storm in all patients with *** the clinical treatment of COVID-19 patients,attention should be paid to the timing of drug administration and other adjuvant treatments.