Medical Department II-the VINFORCE Study Group, Academic Teaching Hospital of the Medical University of Vienna, St. Vincent Hospital Vienna, Stumpergasse 13, 1060, Vienna, Austria.
Department of Neurology, Divine Savior Hospital Vienna, Dornbacher Straße 20-30, 1170, Vienna, Austria.
Wien Klin Wochenschr. 2021 Sep;133(17-18):973-978. doi: 10.1007/s00508-021-01867-2. Epub 2021 Apr 27.
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19), produces protean manifestations and causes indiscriminate havoc in multiple organ systems. This rapid and vast production of proinflammatory cytokines contributes to a condition termed cytokine storm. A 35-year-old, otherwise healthy, employed, male patient was tested positive for COVID-19. He was admitted to the hospital on disease day 10 due to retarded verbal reactions and progressive delirium. On account of these conditions and the need for noninvasive/invasive ventilation, a combination treatment with baricitinib and remdesivir in conjunction with standard of care was initiated. The cytokine storm was rapidly blocked, leading to a vast pulmonary recovery with retarded recovery of the central nervous system. We conclude that the rapid blockade of the COVID-19-induced cytokine storm should be considered of avail as a principle of careful decision-making for effective recovery.
严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)是 2019 冠状病毒病(COVID-19)的病原体,可引起多种临床表现,并在多个器官系统中造成广泛破坏。这种大量产生促炎细胞因子的现象导致了所谓的细胞因子风暴。一名 35 岁的健康男性患者被检测出 COVID-19 呈阳性。由于反应迟钝和进行性意识障碍,他在发病第 10 天被收入医院。鉴于这些情况以及需要无创/有创通气,因此开始联合使用巴瑞替尼和瑞德西韦以及标准护理进行治疗。细胞因子风暴迅速得到抑制,肺部迅速恢复,而中枢神经系统恢复较慢。我们得出结论,迅速阻断 COVID-19 引起的细胞因子风暴应被视为一种有效的恢复决策原则。