Clinical Management of Il-6 Driven Cytokine Storm Related to COVID-19 in a Patient with Recent Spinal Cord Stimulator Implants: A Case Report

Papa, Alfonso; Dato, Maria Teresa Di; Buonavolontà, Pietro; Saracco, Elisabetta; Salzano, Anna Maria; Casale, Beniamino

doi:10.5812/aapm.104151

Cited by 11 publications

(7 citation statements)

References 13 publications

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“…Previous studies reported a wide range of mortality rates among critically ill patients admitted to ICU, from 16% to 38%, 62%, 67%, and 80% (12)(13)(14)(15)(22)(23)(24). In our study, overall outcomes were poor in severe patients who received ICU care, and the mortality rate (84.6%) was considerably higher than other studies.…”

Section: Discussioncontrasting

confidence: 60%

Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

et al. 2020

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Background: World Health Organization (WHO) declared that the outbreak of COVID-19 constituted a public health emergency of global concern. Objectives: Owing to limited data on critically ill patients admitted to ICU, we aimed to describe the clinical characteristics and prognosis of these patients based on ventilatory variables and clinical features. Methods: In this retrospective study, 45 critically ill patients with laboratory-confirmed COVID-19 who were admitted to Intensive Care Unit (ICU) wards of the hospital from April 8 to May 9, 2020, were enrolled. Medical files of the patients were reviewed, and demographic and clinical characteristics, laboratory data, lung CT scan findings, causes of intubation, and outcomes of the patients were all collected. Results: The median age of the patients was 67 years (range 22 to 91), 64% were men, and hypertension was the most common comorbidity. History of close contact with previously confirmed patients was positive in 62.2% of the patients. The mean time from symptom onset to hospital admission was 5.98 ± 2.93 days. The most common symptoms at the onset of illness were dyspnea (95.6%), and gastrointestinal symptoms (22.2%) were rare. The average length of the intubation was 4.84 ± 3.28 days. The distribution of intubation causes in the deceased patients was significantly more than the recovered patients (P = 0.031). The mean score of lung CT involvement in deaths (370.26 ± 207.50) was significantly higher than the recovered patients (235.71 ± 81.21) (P = 0.042). Length of the intubation had a statistically direct correlation with respiratory rate (P = 0.03). Conclusions: Most of the critically ill patients admitted to ICU were older men and had poor outcomes with a high mortality rate. Furthermore, the score of chest CT involvement and respiratory rate are important prognostic factors in determining the severity of the illness, requiring ventilatory support, and outcome.

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Section: Discussioncontrasting

confidence: 60%

Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

et al. 2020

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“…A high IL-6 level is associated with postoperative complications and is recognized as a predictor of morbidity after surgical interventions ( 6 , 7 ). Inhibition of the production of cytokines, including IL-6, can protect the body against traumatic injuries and infections under pathological conditions; therefore, cytokine inhibitors or antagonists may have the capacity to reduce tissue/organ dysfunction ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of General Anesthesia Versus Spinal Anesthesia on Serum Cytokine Release After Cesarean Section: A Randomized Clinical Trial

et al. 2021

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Background: Tissue damage caused by major surgery, such as cesarean section, may lead to a poor host immune response and excessive release of cytokines. These responses may increase the risk of infection, cause postoperative pain, and exert damaging effects on various body organs. Objectives: Anesthesia methods may affect cytokine production after surgery. This study aimed to compare the serum levels of cytokines in general and spinal anesthesia among women undergoing cesarean section. Methods: Thirty parturients (ASA class I and II) undergoing cesarean section were randomly assigned into two equal groups of spinal anesthesia and general anesthesia. Blood samples were taken for measuring the levels of interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) before induction of anesthesia and 30 minutes after entering the recovery room. Results: In the general anesthesia group, the postoperative serum levels of IL-6 and TNF-α were significantly higher than the corresponding preoperative levels. Significant differences were found between the two groups in the preoperative and postoperative levels of TNF-α. Changes in the IL-6 and TNF-α concentrations were significantly higher in the general anesthesia group as compared to the spinal anesthesia group. However, there was no significant difference in the IL-6:IL-10 and TNF-α: IL-10 ratios between the two groups. Conclusions: General anesthesia, as compared to spinal anesthesia, significantly increased the IL-6 and TNF-α levels after cesarean section. Therefore, the spinal anesthesia technique may be a better option for patients undergoing cesarean section.

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“…The distance between patients during recovery should be at least six feet. The number of the medical crew should be kept minimum, and, if possible, the procedure should be conducted in a negative pressure room (16,17).…”

Section: Discussionmentioning

confidence: 99%

Electroconvulsive Therapy for a Patient with Suicide by Drinking Bleach During Treatment of COVID-19: A Case Report

et al. 2020

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: Electroconvulsive therapy (ECT) was first experienced in 1938 and had been conducting without anesthesia for 30 years. In this study, the most common indication for ECT was mood disorder (major depressive disorder and bipolar I disorder). We introduce a patient with a history of COVID-19 and suicide who required emergency ECT. Electroconvulsive therapy can be life-saving in patients with suicide history or catatonic schizophrenia. Health workers are at the front line of the COVID-19 outbreak control and must follow health instructions. Aerosol-producing procedures such as suction in anesthesia for ECT may facilitate the transmission of infectious diseases such as COVID-19. When performing aerosol-producing procedures during the pandemic of novel coronavirus, every patient should be considered suspicious.

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Clinical Management of Il-6 Driven Cytokine Storm Related to COVID-19 in a Patient with Recent Spinal Cord Stimulator Implants: A Case Report

Cited by 11 publications

References 13 publications

Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

Effects of General Anesthesia Versus Spinal Anesthesia on Serum Cytokine Release After Cesarean Section: A Randomized Clinical Trial

Electroconvulsive Therapy for a Patient with Suicide by Drinking Bleach During Treatment of COVID-19: A Case Report

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