Open AccessThromboinflammation response to tocilizumab in COVID‐19
Author(s) -
Gergi Mansour,
Cushman Mary,
Littenberg Benjamin,
Budd Ralph C.
Publication year - 2020
Publication title -
research and practice in thrombosis and haemostasis
Language(s) - English
Resource type - Journals
ISSN - 2475-0379
DOI - 10.1002/rth2.12436
Subject(s) - tocilizumab , medicine , covid-19 , interleukin 6 , coronavirus , pathophysiology , immunology , cytokine release syndrome , inflammation , disease , infectious disease (medical specialty)
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.