195: Tocilizumab for Cytokine Release Syndrome in Severe COVID-19 Pneumonia: A Case Series
Abstract
INTRODUCTION: COVID-19 can induce a significant inflammatory response generating an overwhelming cytokine release that in of itself can be fatal This ?cytokine release syndrome? (CRS), induces profound inflammation affecting nearly all organ systems Interleukin-6 (IL-6) appears to be a major factor driving this process In an attempt to mitigate this inflammatory process and IL-6, Tocilizumab (TCZ), an IL-6 receptor antagonist has been used in COVID-19 We report a series of 7 cases who were diagnosed with severe COVID-19 pneumonia and CRS who received TCZ METHODS: We conducted a retrospective case series evaluating the use of TCZ in patients admitted to the intensive care unit with severe COVID-19 pneumonia and CRS at a single center tertiary care academic hospital in the United States RESULTS: Seven patients met our inclusion criteria All seven patients had at least one co-morbidity and required ICU admission The median age was 57 with each presenting within 7 days of symptom onset All patients had elevated levels of Il-6, CRP, ferritin, and D-dimer TCZ was administered within a median of 3 5 days After 72 hours of TCZ, all patients demonstrated a decrease in CRP levels by >50% and levels continued to downtrend at one week Of the seven, three were extubated within eight days of TCZ administration;two survived to discharge with their mean SOFA score declining from 9 7 pre-treatment to 7 8 over the next 72 hours One developed a secondary infection The five patients that did…
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