van Kraaij Tom DA, Mostard Rémy Lm, Ramiro Sofia, Magro Checa Cesar, van Dongen Christel Mp, van Haren Eric Hj, Buijs Jacqueline, Landewé Robert Bm
Department of Pulmonology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands.
Department of Rheumatology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands.
Eur J Case Rep Intern Med. 2020 Apr 22;7(5):001675. doi: 10.12890/2020_001675. eCollection 2020.
Younger patients with COVID-19 may experience an exaggerated immune response to SARS-CoV-2 infection and develop cytokine release syndrome (CRS), which may be life threatening. There is no proven antiviral therapy for COVID-19 so far, but profound immunosuppression has recently been suggested as a treatment for COVID-19-associated CRS. We present a case of life-threatening CRS caused by COVID-19 infection with a favourable response to immunosuppressive therapy with tocilizumab (TCZ). The rapid clinical and biochemical improvement following TCZ administration suggests that treatment with immunotherapy can be life-saving in selected patients with COVID-19-induced CRS.
Cytokine release syndrome may cause sudden and potentially life-threatening clinical deterioration in COVID-19 pneumonia, particularly in younger patients.Immunosuppressive therapy may provide important additional therapeutic benefit in these patients.Tocilizumab, a specific IL-6 inhibitor, led to dramatic clinical improvement in a young patient with severe COVID-19-associated cytokine release syndrome.
感染新型冠状病毒肺炎（COVID-19）的年轻患者可能对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染产生过度免疫反应，并发展为细胞因子释放综合征（CRS），这可能危及生命。目前尚无经证实的针对COVID-19的抗病毒疗法，但最近有人提出深度免疫抑制可作为治疗COVID-19相关CRS的方法。我们报告一例由COVID-19感染引起的危及生命的CRS病例，该病例对托珠单抗（TCZ）免疫抑制治疗反应良好。给予TCZ后临床和生化指标迅速改善，表明免疫疗法治疗某些COVID-19诱导的CRS患者可挽救生命。
细胞因子释放综合征可能导致COVID-19肺炎突然出现且可能危及生命的临床恶化，尤其是在年轻患者中。免疫抑制治疗可能为这些患者提供重要的额外治疗益处。托珠单抗，一种特异性白细胞介素-6抑制剂，使一名患有严重COVID-19相关细胞因子释放综合征的年轻患者临床症状显著改善。
