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Therapeutic potential of anticoagulant therapy in association with cytokine storm inhibition in severe cases of COVID-19: A case report
Open Life Sciences ( IF 2.2 ) Pub Date : 2021-08-23 , DOI: 10.1515/biol-2021-0088
Qiancheng Xu 1 , Tao Wang 1 , Weihua Lu 1
Affiliation  

Inflammation and coagulation are considered to the development of Coronavirus disease 2019 (COVID-19)-related hypoxemia. However, this is still controversial, which brings challenges to clinical treatment. Here, we reviewed the levels of interleukin-6 (IL-6), coagulation indexes, and clinical manifestations of a patient with severe COVID-19 after Tocilizumab administration. In this case, the patient’s body temperature quickly dropped to normal after using Tocilizumab, while C reactive protein progressively decreased and stabilized at a lower level. However, IL-6 and D-dimers increased and were accompanied by a continuous decrease of the oxygenation index. After anticoagulant therapy with heparin, D-dimer decreased slowly, gradually improving the oxygenation index and disease remission. This case suggests that the formation of microthrombus might be the main reason for COVID-19-derived hypoxemia. However, the mechanism of hypoxemia and the role of Tocilizumab in COVID-19 need further research. Nevertheless, these findings might still assist medical workers in formulating timely treatment strategies for similar severe patients.

中文翻译:

在 COVID-19 重症病例中抗凝治疗与细胞因子风暴抑制相关的治疗潜力:病例报告

炎症和凝血被认为与 2019 年冠状病毒病 (COVID-19) 相关低氧血症的发生有关。然而,这仍然存在争议,这给临床治疗带来了挑战。在这里,我们回顾了 Tocilizumab 给药后重症 COVID-19 患者的白细胞介素 6 (IL-6) 水平、凝血指标和临床表现。本例患者使用托珠单抗后体温迅速下降至正常,而C反应蛋白逐渐下降并稳定在较低水平。然而,IL-6 和 D-二聚体增加,并伴随着氧合指数的持续下降。肝素抗凝治疗后,D-二聚体缓慢下降,氧合指数逐渐改善,病情缓解。该病例表明微血栓的形成可能是 COVID-19 引起的低氧血症的主要原因。然而,低氧血症的机制以及托珠单抗在 COVID-19 中的作用需要进一步研究。尽管如此,这些发现仍可能有助于医务人员为类似的重症患者制定及时的治疗策略。
更新日期:2021-08-23
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