Khalid Mansoor, Dernaika Tarek, Jacob Lirin, Annamaraju Pavan, Guddati Achuta K
Mercy Hospital, Oklahoma City, Oklahoma, USA.
Johnston Memorial Hospital, Ballad Health System, Abingdon, Virginia, USA.
Case Rep Oncol. 2020 Jun 29;13(2):754-759. doi: 10.1159/000509507. eCollection 2020 May-Aug.
Patients with novel corona virus infection (COVID-19) can develop acute respiratory failure secondary to acute respiratory distress syndrome. Cytokine storm is suggested as one of underlying mechanisms for the rapid clinical decline. Immunocompromised patients and cancer patients are at particular risk for poor outcomes due to COVID-19 infection. This case report describes the presentation and clinical course of a cancer survivor who became critically ill and required mechanical ventilation. The patient was treated with hydroxychloroquine, azithromycin, and ceftriaxone; however, he remained febrile, hypoxemic, continued to require full mechanical ventilator support and his chest X-ray showed increased bilateral infiltrates. The patient was treated with tocilizumab, after which he improved and was successfully extubated. This report illustrates a possible role of tocilizumab in management of cytokine storm in critically ill patients with COVID-19 infection.
新型冠状病毒感染（COVID-19）患者可继发于急性呼吸窘迫综合征而出现急性呼吸衰竭。细胞因子风暴被认为是导致临床迅速恶化的潜在机制之一。免疫功能低下患者和癌症患者因COVID-19感染而出现不良预后的风险尤其高。本病例报告描述了一名癌症幸存者的临床表现和病程，该患者病情危重，需要机械通气。患者接受了羟氯喹、阿奇霉素和头孢曲松治疗；然而，他仍发热、低氧血症，持续需要完全机械通气支持，胸部X线显示双侧浸润增加。患者接受了托珠单抗治疗，之后病情好转并成功脱机。本报告说明了托珠单抗在治疗COVID-19感染危重症患者细胞因子风暴中的可能作用。
