Role of Tocilizumab in the Treatment of COVID-19 Patients with Cytokine Storm: A Case Series

Authors

  • Ajaya Basnet Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Maharajgunj, Kathmandu, Nepal
  • Mahendra Raj Shrestha Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
  • Rossu Thapa Department of Radiology, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
  • Basanta Tamang Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
  • Apurba Shrestha Department of Internal Medicine, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
  • Prabhat Rawal Department of Anaesthesiology and Critical Care, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
  • Sailendra Kumar Duwal Shrestha Department of Orthopedic and Trauma Services, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
  • Lochan Karki Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Mahaboudha, Kathmandu, Nepal
  • Shiba Kumar Rai Research Department, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal

DOI:

https://doi.org/10.31729/jnma.7364

Keywords:

COVID-19; cytokines; interleukin-6.

Abstract

The in-hospital mortality in patients with COVID-19 could be correlated with severe acute respiratory syndrome coronavirus-2 induced hyper-inflammation, which is attributed to an unconstrained inflammatory cytokine storm. The pro-inflammatory cytokine, specifically, interleukin-6 plays a prominent role in the cytokine storm and may result in alveolar-capillary blood-gas exchange dysfunction. Therefore, the method to block the signal transduction pathway of interleukin-6 could be a potential treatment for severe COVID-19 patients. In this case series of three patients with severe COVID-19, we focus on the rationale for utilization of tocilizumab, an anti-interleukin-6 receptor antibody, which could block the signal transduction pathway of interleukin-6. The observations from this study allowed us to hypothesize that the infusions of tocilizumab may not reduce the elevated level of interleukin-6, and hence may not be a significant therapeutic for reducing in-hospital mortality associated with COVID-19. Additionally, it could also be speculated that interleukin-6 may not be a potentially actionable target cytokine to treat COVID-19-associated cytokine storms.

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Published

2022-08-01

How to Cite

Basnet, A. ., Shrestha, M. R. ., Thapa, R. ., Tamang, B. ., Shrestha, A. ., Rawal, P. ., Duwal Shrestha, S. K. ., Karki, L., & Rai, S. K. . (2022). Role of Tocilizumab in the Treatment of COVID-19 Patients with Cytokine Storm: A Case Series. Journal of Nepal Medical Association, 60(252), 727–731. https://doi.org/10.31729/jnma.7364

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