What are the main factors affecting the outcome of tocilizumab therapy in COVID-19-induced cytokine release syndrome?

Akleylek, Cansu; Gür, Seray Gizem; Sever, İbrahim Halil; Demir, Safiye Koçulu; Çevik, Esin; Eken, Egemen; Gökkaya, Zafer; Çağatay, Yonca; Yılmaz, Neslihan

doi:10.5152/eurjrheum.2022.21010

Cited by 3 publications

(4 citation statements)

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“…Studies of Tocilizumab in COVID-19 have given conflicting results, which may reflect lack of standard protocols for its use [ [16] , [17] , [18] , [19] , [20] ]. Initial trials demonstrated no clear benefit of Tocilizumab monotherapy on survival, length of hospital stay, need for mechanical ventilation, disease progression or time to recovery [ [21] , [22] , [23] , [24] , [25] , [26] ].…”

Section: Discussionmentioning

confidence: 99%

Association between tocilizumab treatment of hyperinflammatory patients with COVID-19 in a critical care setting and elevated incidence of hospital-acquired bacterial and invasive fungal infections

Minihan

McAuliffe

Powell

et al. 2022

Journal of Hospital Infection

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Section: Discussionmentioning

confidence: 99%

Association between tocilizumab treatment of hyperinflammatory patients with COVID-19 in a critical care setting and elevated incidence of hospital-acquired bacterial and invasive fungal infections

Minihan

McAuliffe

Powell

et al. 2022

Journal of Hospital Infection

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“…Some studies have reported that treatment with tocilizumab contributes to reduced mortality and favorable outcomes [144,145]. Conversely, another study noted that tocilizumab demonstrated limited efficacy for COVID-19-related MAS [146]. In another recent trial, tocilizumab led to an increased incidence of secondary infections among critically ill patients with COVID-19-associated MAS, while treatment with anakinra resulted in favorable responses [147].…”

Section: Therapeutic Optionsmentioning

confidence: 99%

Macrophage Activation Syndrome in Viral Sepsis

Papageorgiou,

Gogos,

Akinosoglou

2024

Viruses

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Macrophage activation syndrome (MAS) is a life-threatening systemic hyperinflammatory syndrome triggered by various infections, particularly viral infections, autoimmune disorders, and malignancy. The condition is characterized by an increased production of proinflammatory cytokines resulting in a cytokine storm and has been associated with poor clinical outcomes. During the COVID-19 pandemic, patients with severe manifestations developed features similar to those of MAS, although these characteristics remained well defined within the lung. Additionally, other viral infections including EBV, the herpes family of viruses, hepatitis viruses, influenza, HIV, and hemorrhagic fevers can be complicated by MAS. The diagnosis and management of the condition remain challenging due to the lack of consensus on specific guidelines, especially among the adult population. Currently, therapeutic options primarily rely on medications that are typically used to treat primary hemophagocytic lymphohistiocytosis, such as corticosteroids and etoposide. In addition, cytokine-targeted therapies present promising treatment options. The objective of this review is to discuss the emergence of MAS in the context of viral infections including, but not limited to, its occurrence in COVID-19.

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“…In some cases with severe COVID-19, a multisystemic hyperinflammation (mHI; persistent fever, skin rashes, elevated proinflammatory cytokines, multiorgan dysfunction, and hepatosplenomegaly) can occur. 59 , 60 An mHI characterized by clinical features similar to Kawasaki disease or toxic shock syndrome has also been described in children with COVID-19 [multisystem inflammatory syndrome in children (MIS-C)]. 60 Although MIS-C is predominantly characterized by cardiopulmonary abnormalities (heart failure, cardiomegaly, myocarditis, coronary artery aneurysms, pulmonary edema, pleural effusion, pericardial effusion, consolidation, and ARDS), hepatomegaly, ascites, and intestinal abnormalities were reported.…”

Section: Imaging Findings Of Covid-19 Pneumoniamentioning

confidence: 99%

“… 60 , 61 Rarely, an MIS in adults, characterized by markedly elevated proinflammatory cytokines and multiorgan dysfunction similar to MIS-C, can be seen. 59 …”

Section: Imaging Findings Of Covid-19 Pneumoniamentioning

confidence: 99%

COVID-19 pneumonia: lessons learned, challenges, and preparing for the future

Ufuk

Savaş

2022

Diagn Interv Radiol

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Coronavirus disease 2019 (COVID-19) is a viral disease that causes life-threatening health problems during acute illness, causing a pandemic and millions of deaths. Although computed tomography (CT) was used as a diagnostic tool for COVID-19 in the early period of the pandemic due to the inaccessibility or long duration of the polymerase chain reaction tests, current studies have revealed that CT scan should not be used to diagnose COVID-19. However, radiologic findings are vital in assessing pneumonia severity and investigating complications in patients with COVID-19. Long-term symptoms, also known as long COVID, in people recovering from COVID-19 affect patients’ quality of life and cause global health problems. Herein, we aimed to summarize the lessons learned in COVID-19 pneumonia, the challenges in diagnosing the disease and complications, and the prospects for future studies.

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What are the main factors affecting the outcome of tocilizumab therapy in COVID-19-induced cytokine release syndrome?

Cited by 3 publications

References 0 publications

Association between tocilizumab treatment of hyperinflammatory patients with COVID-19 in a critical care setting and elevated incidence of hospital-acquired bacterial and invasive fungal infections

Association between tocilizumab treatment of hyperinflammatory patients with COVID-19 in a critical care setting and elevated incidence of hospital-acquired bacterial and invasive fungal infections

Macrophage Activation Syndrome in Viral Sepsis

COVID-19 pneumonia: lessons learned, challenges, and preparing for the future

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