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Background: The novel coronavirus, which causes Covid-19 disease and is called severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) by the World Health Organization, was first seen in Wuhan, China in December 2019 and initiated a pandemic on a global scale. Uncontrolled cytokine production is observed in Covid-19 cases with severe progression, and this is thought to be one of the reasons for increased mortality. We applied Coupled Plasma Filtration Adsorption (CPFA) and Tocilizumab treatments to patients who were hospitalized in our intensive care unit due to Covid-19 disease and who thought that cytokine release syndrome and/or cytokine storm developed after the uncontrolled cytokine production triggered by the SARS-CoV-2 virus. In our study, we aimed to evaluate the effectiveness of these treatments through retrospective file and archive scanning. Materials and Methods: Patients who had hospitalized in our intensive care unit between February and June 2020 due to Covid-19 disease, were thought to have developed cytokine release syndrome and/or cytokine storm, and were treated with CPFA or Tocilizumab were included in our study. Our study was planned by retrospectively scanning the data of 20 patients from each treatment group. CPFA treatments were applied for 10 hours each session and 2 sessions with a 12-hour break. Tocilizumab administration was made intravenously within 1 hour from 8 mg/kg dose to a maximum of 800 mg. Before CPFA and Tocilizumab treatments and in the 24th, 48th hour and 7th day after CPFA and Tocilizumab treatments, Sequential Organ Failure Assessment scores(SOFA), Horowitz indexes(PaO2/FiO2), fever, inotrope requirements, SpO2 and relevant laboratory values (IL-6, Lymphocyte count, CRP, D-dimer) were obtained from patient files and systemic data. Results: After CPFA and Tocilizumab treatments, a decrease in fever and IL-6 values, an increase in SpO2 and lymphocyte values, an increase in Horowitz and SOFA scores, and a decrease in CRP and D dimer values were observed. The increase in SpO2 and Horowitz score values was significantly higher in the CPFA group. At the end of the 7th day, a decrease in fever values and an increase in SOFA scores and a decrease in CRP - D dimer values were significantly more pronounced in the CPFA group. A decrease in inotropic support was observed in the CPFA group. Conclusion: In Covid-19 disease, the disease has a more severe course with cytokine release syndrome and/or cytokine storm that develops after the deterioration of the immune system. Inflammatory cytokine production was controlled with CPFA and Tocilizumab treatments, and improvements were achieved in the oxygenation and clinical findings of the patients. [ABSTRACT FROM AUTHOR]

Objective: In this retrospective study, we assessed if the admission levels of interleukin (IL)-6 and other inflammatory parameters corralate with the extension of lung involvement on computed tomography (CT) in severe-critical COVID patients. Materials and Methods: Ninety patients with a diagnosis of COVID-19 in the intensive care unit were included; however, 30 of these patients who were diagnosed as COVID-19 [polymerase chain reaction (PCR), CT, or history-clinical presentation-laboratory] and whose CT and IL-6 inflamatory parameter results could be obtained were finally analyzed. Admission CT scan findings were analyzed according to a 40-point system, and compared to the admission levels of plasma IL-6 as well as c-reactive protein, procalcitonin, lymphocyte, and neutrophyl/lymphocyte ratios. Results: No correlation was found between the IL-6 levels and CT scores taken in the same time period. IL-6 levels were corraleted with procalcitonin levels and mortality rate ssuggesting that bacterial infections were supervened on the clinical scene of these patients. Conclusion: In our study, we could not show any correlation between CT scores and an elevation of IL-6 levels. The role of the cytokine storm in COVID-19 pneumonia that manifests with cell death, thrombotic sequences, and alveolar edema might be explained by ongoing studies. [ABSTRACT FROM AUTHOR]