CASE REPORT   Open access

Italian Journal of Emergency Medicine 2020 December;9(3):142-4

DOI: 10.23736/S2532-1285.20.00028-2

Copyright © 2020 THE AUTHORS

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language: English

Acute respiratory distress syndrome in COVID-19: experience with cytokine inhibitors

Francesco S. SERINO ¹ ✉, Lucio BROLLO ², Fabio TOFFOLETTO ³

¹ Unit of Infectious Diseases, Department of Medicine, ASL 4 Veneto Orientale, Portogruaro, Venice, Italy; ² Unit of Infectious Diseases, Department of Medicine, ASL 4 Veneto Orientale, Jesolo, Venice, Italy; ³ Unit of Anesthesia and Intensive Care, Critical Area Department, ASL 4 Veneto Orientale, Jesolo, Venice, Italy

Clinical manifestations of SARS-CoV-2 infection (COVID-19) are extremely variable. The severity of the clinical presentation picture is associated with the age and presence of comorbidity, although some unfavorable prognosis risk factors are not yet clearly recognized. We describe the case of a patient with ARDS undergoing currently available antiviral treatments, as well as drugs that inhibit the cytokine cascade, through clinical trials or compassionate uses. In our case the unexpected and subsequent use of two anti-IL-6 molecules allowed the inhibition of the cytokine cascade at different times contributing to the improvement of the outcomes.

KEY WORDS: COVID-19; Tocilizumab; Respiratory distress syndrome, adult