Experience of tocilizumab use for treatment of cytokine storm in patient with severe course of virus pneumonia caused by SARS-CoV-2 (Case report)

Abstract

A clinical observation of tocilizumab efficacy for treatment of "cytokine storm" is presented in a patient with severe acute respiratory infection caused by SARS-CoV-2. Patient K., 57 years old with rapid progression of pneumonia caused by SARS-CoV-2 was admitted to hospital CHUZ " KB "RZDMeditsina" named after N. A. Semashko " on May 8, 2020, with complaints of fever up to 38,5°C for 5 days, cough and weakness. During 10 days of inpatient treatment, the patient's condition did not improve, shortness of breath increased (SpO290%, with oxygen therapy), the patient suffered from dry cough and fever up to 38,5°C. Due to increase in inflammatory process, manifested by an increase in C-reactive protein (CRP) > 75 mg/l, fever > 38°C, decrease in SpO2< 90%, leukopenia < 1,0 × 109/l, an increase in ferritin >1000 ng/ml in combination with a 70% (CT3) lesion of the lung tissue according to computed tomography, the patient was administered 160 mg of inteleukin -6 receptor blocker tocilizumab intravenously. In the next 48 hours of observation, the patient noted the disappearance of fever, an increase in SpO2to 94%, and a significant improvement in laboratory parameters. The effectiveness of tocilizumab can be explained by blocking interleukin-6-associated inflammatory response and requires further study in randomized clinical trials.