ABSTRACT

We describe the case of a 42 year old, healthy patient with Covid-19 who despite improvement in his respiratory symptoms developed a mild to moderate cytokine release syndrome (CRS) and an associated monoarticular gout flare. Since the patient refused admission to the hospital and had stable vital signs, we chose to treat him with a safe anti-inflammatory and non-immunosuppressive therapy. To hit two birds with one stone, we considered colchicine, as it has systemic anti-inflammatory effects and is also effective in gout flare. Unexpectedly, 48 hours after treatment, not only did his ongoing fever and toe pain disappear, he also had significant improvements in his general state of health and all his inflammatory markers including fibrinogen, ferritin, D-dimer, and IL-6 levels normalized. To our knowledge, the use of colchicine in Covid-19 and CRS has not been reported. This observation merits the consideration of colchicine as a safe, inexpensive and oral medication for the treatment of mild to moderate CRS in Covid-19 patients. More importantly, in Covid-19 patients with early lung involvement colchicine may be an appropriate candidate to prevent CRS in adjunction with routine antiviral agents. Indeed, multicenter, randomized controlled studies are required to evaluate the benefits of this therapy.

 抽象的

我们描述了一名 42 岁健康 Covid-19 患者的病例，尽管他的呼吸道症状有所改善，但仍出现了轻度至中度细胞因子释放综合征 (CRS) 和相关的单关节痛风发作。由于患者拒绝入院且生命体征稳定，我们选择采用安全的抗炎非免疫抑制治疗。为了一石二鸟，我们考虑使用秋水仙碱，因为它具有全身抗炎作用，并且对痛风发作也有效。出乎意料的是，治疗48小时后，他不仅持续发烧和脚趾疼痛消失，整体健康状况也显着改善，包括纤维蛋白原、铁蛋白、D-二聚体和IL-6在内的所有炎症标志物水平均恢复正常。据我们所知，尚未有在 Covid-19 和 CRS 中使用秋水仙碱的报道。这一观察结果值得考虑将秋水仙碱作为一种安全、廉价的口服药物，用于治疗 Covid-19 患者的轻度至中度 CRS。更重要的是，在早期肺部受累的 Covid-19 患者中，秋水仙碱可能是联合常规抗病毒药物预防 CRS 的合适候选者。事实上，需要多中心、随机对照研究来评估这种疗法的益处。