Abstract
We thank Lim and colleagues [1] for questioning how best to modulate complement pathway to improve outcomes of patients with COVID-19. In our study, we found that in patients with severe COVID-19, eculizumab treatment associated reduction in soluble C5b-9 paralleled the reduction of the concentrations of circulating proinflammatory cytokines and arterial lactate [2]. To explore the effects of eculizumab treatment on the second limb of the terminal complement pathway, we retrospectively measured C5a concentrations at baseline, day-1 and day-7 in 44/80 patients (14/45 and 30/35 in the eculizumab free and treated, respectively).
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