Department of Pulmonology, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia.
Cytokine. 2021 Feb;138:155393. doi: 10.1016/j.cyto.2020.155393. Epub 2020 Dec 14.
COVID-19 is a public health emergency of international concern with millions confirmed cases globally including in Indonesia with more than two hundred thousand confirmed cases to date COVID-19. (1) COVID-19 has wide clinical manifestation ranging from asymptomatic, acute respiratory illness, respiratory failure that necessitates mechanical ventilation and support in an ICU, to MODS. (2) Several comorbidities have been demonstrated to be associated with the development of severe outcomes from COVID-19 infection, such as hypertension, diabetes, cardiovascular disease, dyslipidemia, thyroid disease, and pulmonary disease. (3)-(5) Severe COVID-19 is associated with increased plasma concentrations of IL-6, resulting in cytokine storm. (6) Tocilizumab, an interleukin-6 inhibitor, might alleviates the cytokine storm, prevents significant lungs and organs damage, thus improving clinical outcomes. (7) Therefore, tocilizumab, might be one of the promising therapies for severe COVID-19. (8) However there were limited studies regarding the efficacy in COVID-19 patients, especially with control group. We would like to report our experience in using tocilizumab as treatment in severe COVID-19 patients in Indonesia, which is the first in Indonesia to the best of our knowledge.
COVID-19 是一个国际关注的公共卫生紧急事件，全球已有数百万人确诊，包括印度尼西亚，截至目前已有超过 20 万例确诊病例。COVID-19 的临床表现广泛，从无症状、急性呼吸道疾病、需要机械通气和 ICU 支持的呼吸衰竭，到多器官功能障碍综合征。已经证明，一些合并症与 COVID-19 感染的严重后果的发展有关，如高血压、糖尿病、心血管疾病、血脂异常、甲状腺疾病和肺部疾病。严重的 COVID-19 与 IL-6 血浆浓度的升高有关，导致细胞因子风暴。白细胞介素 6 抑制剂托珠单抗可能缓解细胞因子风暴，防止肺部和其他器官的严重损伤，从而改善临床结果。因此，托珠单抗可能是治疗严重 COVID-19 的一种有前途的疗法。然而，关于 COVID-19 患者疗效的研究有限，特别是对照研究。我们希望报告我们在印度尼西亚使用托珠单抗治疗严重 COVID-19 患者的经验，据我们所知，这是印度尼西亚首例。
