1. Clinical benefits of Tocilizumab in COVID‐19‐related cytokine release syndrome in a patient with end‐stage kidney disease on haemodialysis in Australia.
- Author
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Stephen, Shiny, Park, Yeung‐Ae, and Chrysostomou, Anastasia
- Subjects
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CYTOKINE release syndrome , *CHRONIC kidney failure , *TOCILIZUMAB , *COVID-19 treatment , *HEMODIALYSIS patients - Abstract
COVID‐19 remains a global pandemic with more than 10 million cases and half a million deaths worldwide. The disease manifestations in patients with chronic kidney disease and especially those on haemodialysis are still being understood, with only a few overseas case series, and small observational trials thus far. It appears that the disease is more severe in this patient cohort. Part of the pathophysiology of severe COVID‐19 is related to accompanying cytokine release syndrome (CRS). Tocilizumab, an interleukin‐6 inhibitor, has been trialled for treatment of CRS in COVID‐19, but not yet approved. We present a case of an Australian patient on long‐term haemodialysis with severe COVID‐19 who was successfully treated with Tocilizumab. The peak of her illness was on day 7, with a C‐reactive protein of 624 mg/L (reference < 5 mg/L), ferritin of 5293 ng/mL (reference 30‐500 ng/mL), and interleukin‐6 level 1959.7 pg/mL, consistent with CRS. She was severely hypoxic on a ventilator, with rising inotropic requirements. With the use of Tocilizumab, there was a significant and immediate response in her inflammatory markers, and she made a steady recovery. The patient was discharged home 6 weeks after presentation. SUMMARY AT A GLANCE: A report of an elderly long‐term haemodialysis patient who successfully recovered from a cytokine release syndrome due to severe COVID‐19 using an IL‐6 inhibitor, tocilizumab. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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