Background: Tocilizumab, an inhibitor of the interleukin-6 receptor, may decrease the inflammatory response and control the symptoms of severe coronavirus disease 2019 (COVID-19), but the evidence is scarce. Methods: This retrospective study included patients with severe COVID-19 requiring oxygen therapy who received tocilizumab in seven centers across Poland. We assessed on-treatment changes in clinical status and inflammatory markers. Results: Twenty-eight patients were included (19 male), with a mean age of 61.7 ± 12.4 years. The mean time from symptom onset to the first tocilizumab dose was 10.5 ± 5.7 days. Clinical status improved within 24 hours in 11 (39%) patients, within one week in 23 (82%) patients, and within two weeks in 25 (89%); one (4%) patient showed no change and two (7%) patients died. Sixteen patients (57%) no longer needed oxygen therapy within a week (p < 0.001). The serum concentrations of C-reactive protein, procalcitonin, and fibrinogen decreased significantly (p ≤ 0.001). Lung changes improved in 21 (84%) patients within two weeks of treatment; 19 had minimal or no changes upon final examination. Conclusions: Tocilizumab can control the symptoms of severe COVID-19 by reducing the inflammatory response and rapidly improves the clinical status in most patients.
Introduction.The AIDS disease epidemic is still a global problem. To date, finding the connection between HIV and SARS-CoV-2 infection is very significant. Case Report. A 51-year-old woman was admitted to the Neurology Department due to neurological symptoms lasting for 1.5 months. Imaging examinations of the CNS, chest CT and cerebrospinal fluid examination revealed significant abnormalities. Tests for HIV and SARS-CoV-2 were both positive. Klebsiella pneumoniae ESBL+ was detected in rectal swab as well as findings of Candida antigens and antibodies of Cryptococcus neoformans mycosis in serum. Due to these results, appropriate treatment was implemented but with with a time delay which resulted in the death of the patient. Conclusion. HIV infection may be associated with an increased risk of severe SARS-CoV-2 infection causing an increase in mortality rate during the COVID-19 pandemic. Confirmation and early detection of HIV infection permits early and accurate diagnosis and faster treatment decisions.
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