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Colegio de Medicina Interna de México.

2022, Number 4

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Med Int Mex 2022; 38 (4)

Cytokine release syndrome in infection due to COVID-19 and administration of tocilizumab as therapeutic option

Prado-Rodríguez M, Robles-Abarca Y, González-Rocha BL, Soler-Delgado F, Esquivel-Victoria CM, Loza-Jalil SE

Language: Spanish
References: 32
Page: 877-886
PDF size: 234.59 Kb.


ABSTRACT

The novel severe acute respiratory syndrome coronavirus (SARS-CoV-2), causing of coronavirus disease 2019 (COVID-19), is resulting in a worldwide pandemic and has affected more than 200 countries, leading in more than 10 million cases with 508,000 confirmed deaths. The disease spectrum is wide from mild symptoms to severe pneumonia, and some critical conditions be able to produce life-threatening complications, particularly in patients with cytokine release syndrome. This is characterized by dyspnea, hypoxemia and bilateral lung infiltrates on chest radiographic imaging, in case of disease progression invasive mechanical ventilation is needed. The clinical presentation includes hypotension, fever, septic shock with vasopressor therapy, endothelial injury, disseminated intravascular coagulation and multi-organic failure. The most relevant paraclinical parameters associated to cytokine release syndrome are cytopenias, elevated levels of inflammatory cytokines, transaminasemia, coagulation abnormalities and increment in C-reactive protein values. Tocilizumab is a humanized monoclonal antibody against the interleukin-6 receptor (IL-6r), it has been successful administrated in cytokine release syndrome. We propose the blockage with tocilizumab in patients who fulfilled the clinical criteria of cytokine release syndrome based on the literature review as a therapeutic target for COVID-19 infection.


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