Anti-interleukin-6 monoclonal antibody for cytokine storm in COVID-19

Douedi, Steven; Chaudhri, Moiuz; Miskoff, Jeffrey A

doi:10.4103/atm.atm_286_20

Cited by 10 publications

(13 citation statements)

References 9 publications

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“…Capoferri et al found in their studies that of the inflammatory markers, interleukin‐6 had the strongest correlation with relative bradycardia and other arrhythmias 7 . Interleukin‐6 is a significant inflammatory marker associated with the cytokine storm seen in COVID‐19 infection and has been reported to have direct impact on the sinoatrial node causing increased vagal tone and minimized heart rate variability ultimately leading to relative bradycardia 27‐29 . In addition to these hypotheses, as the disease course worsens arrhythmias are likely worsened by the hypoxia and multiorgan failure, resulting in electrolyte derangements and buildup of toxic metabolites 5,10 …”

Section: Mechanism Of Cardiac Involvementmentioning

confidence: 99%

COVID‐19 induced bradyarrhythmia and relative bradycardia: An overview

Douedi

Mararenko

Alshami

et al. 2021

Journal of Arrhythmia

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Novel coronavirus 2019 (COVID‐19) has been the focus of the medical community since its emergence in December 2019 and has already infected more than 100 million patients globally. Primarily described to cause a respiratory illness, COVID‐19 has been found to affect almost every organ system. Bradycardia is a newly recognized ramification of COVID‐19 that still has unknown prognostic value. Studies have shown an increase in the incidence of arrhythmias, cardiomyopathies, myocarditis, acute coronary syndromes, and coagulopathies in infected patients as well as an increased risk of mortality in patients with preexisting cardiovascular disease. While the pathogenesis of bradycardia in COVID‐19 may be multifactorial, clinicians should be aware of the mechanism by which COVID‐19 affects the cardiovascular system and the medication side effects which are used in the treatment algorithm of this deadly virus. There has yet to be a comprehensive review analyzing bradyarrhythmia and relative bradycardia in COVID‐19 infected patients. We aim to provide a literature review including the epidemiology, pathogenesis, and management of COVID‐19 induced bradyarrhythmia.

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Section: Mechanism Of Cardiac Involvementmentioning

confidence: 99%

COVID‐19 induced bradyarrhythmia and relative bradycardia: An overview

Douedi

Mararenko

Alshami

et al. 2021

Journal of Arrhythmia

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“…Similarly to anakinra and corticosteroids, TCZ has been employed as supportive therapy in COVID-19 to manage symptoms of hyper-inflammation and other immune responses. Several published case series and reports observed remarkable clinical responses following the use of TCZ in COVID-19 patients, including the clinical resolution of septic shock, reduction in the markers of inflammation, enhanced negative conversion, and reduced need for invasive mechanical ventilation [128][129][130][131][132][133][134][135][136][137][138][139].…”

Section: Tocilizumabmentioning

confidence: 99%

“…Patient experienced remarkable recovery and was discharged to home 5 days after TCZ use. [133] TCZ; case series 5 critically ill COVID-19 patients whose illness was refractory to standardized treatment.…”

Section: Drug and Study Type Description Findings Referencesmentioning

confidence: 99%

Clinical Management of COVID-19: A Review of Pharmacological Treatment Options

et al. 2021

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Since the outbreak and subsequent declaration of COVID-19 as a global pandemic in March 2020, concerted efforts have been applied by the scientific community to curtail the spread of the disease and find a cure. While vaccines constitute a vital part of the public health strategy to reduce the burden of COVID-19, the management of this disease will continue to rely heavily on pharmacotherapy. This study aims to provide an updated review of pharmacological agents that have been developed and/or repurposed for the treatment of COVID-19. To this end, a comprehensive literature search was conducted using the PubMed, Google Scholar, and LitCovid databases. Relevant clinical studies on drugs used in the management of COVID-19 were identified and evaluated in terms of evidence of efficacy and safety. To date, the FDA has approved three therapies for the treatment of COVID-19 Emergency Use Authorization: convalescent plasma, remdesivir, and casirivimab/imdevimab (REGN-COV2). Drugs such as lopinavir/ritonavir, umifenovir, favipiravir, anakinra, chloroquine, hydroxychloroquine, tocilizumab, interferons, tissue plasminogen activator, intravenous immunoglobulins, and nafamosat have been used off-label with mixed therapeutic results. Adjunctive administration of corticosteroids is also very common. The clinical experience with these approved and repurposed drugs is limited, and data on efficacy for the new indication are not strong. Overall, the response of the global scientific community to the COVID-19 pandemic has been impressive, as evident from the volume of scientific literature elucidating the molecular biology and pathophysiology of SARS-CoV-2 and the approval of three new drugs for clinical management. Reviewed studies have shown mixed data on efficacy and safety of the currently utilized drugs. The lack of standard treatment for COVID-19 has made it difficult to interpret results from most of the published studies due to the risk of attribution error. The long-term effects of drugs can only be assessed after several years of clinical experience; therefore, the efficacy and safety of current COVID-19 therapeutics should continue to be rigorously monitored as part of post-marketing studies.

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“…Coronavirus 2019 (COVID-19) became a public health international emergency in December 2019 leading to hundreds of thousands of deaths to date [ 1 , 2 ]. COVID-19, caused by an enveloped RNA virus, is known to cause severe pneumonia with complications that lead to acute respiratory distress syndrome (ARDS), cytokine storm, and disseminated intravascular coagulation (DIC) [ 1 , 3 - 5 ]. Several cases have reported spontaneous pneumomediastinum and pneumothorax secondary to COVID-19; however, the underlying pathophysiology remains to be understood and pneumopericardium still remains uncommon [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Associated Spontaneous Pneumothorax and Pneumopericardium: A Case Report

Bistre¹,

Douedi²,

Alshami³

et al. 2021

Cureus

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Novel coronavirus 2019 (COVID-19) has been one of the largest and most devastating global pandemics of our time. There have been several complications of this disease that have also proven to be debilitating and deadly. While primarily affecting the respiratory system, some cases presented with uncommon complications such as pneumopericardium and spontaneous pneumothorax. We present a case of an elderly female diagnosed with COVID-19 found to have both spontaneous pneumothorax and pneumopericardium. She had a complicated hospital course and ultimately succumbed to her illness. While the pathogenesis of these conditions is not yet fully understood, further studies are needed to help clinicians develop treatment and prevention strategies to improve patient outcomes.

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Anti-interleukin-6 monoclonal antibody for cytokine storm in COVID-19

Cited by 10 publications

References 9 publications

COVID‐19 induced bradyarrhythmia and relative bradycardia: An overview

COVID‐19 induced bradyarrhythmia and relative bradycardia: An overview

Clinical Management of COVID-19: A Review of Pharmacological Treatment Options

COVID-19 Associated Spontaneous Pneumothorax and Pneumopericardium: A Case Report

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