Combination of thrombolytic and immunosuppressive therapy for coronavirus disease 2019: A case report.
Aged
Antibodies, Monoclonal, Humanized
/ therapeutic use
Betacoronavirus
COVID-19
Coronavirus Infections
/ drug therapy
Drug Combinations
Fibrinolytic Agents
/ therapeutic use
Humans
Immunosuppressive Agents
/ therapeutic use
Male
Pandemics
Pneumonia, Viral
/ drug therapy
SARS-CoV-2
Tissue Plasminogen Activator
/ therapeutic use
COVID-19 Drug Treatment
Acute respiratory distress syndrome
Coronavirus disease 2019
D-dimer
Recombinant tissue plasminogen activator
Tocilizumab
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
12
05
2020
revised:
27
05
2020
accepted:
28
05
2020
pubmed:
5
6
2020
medline:
4
8
2020
entrez:
5
6
2020
Statut:
ppublish
Résumé
In a proportion of patients, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a multisystem syndrome characterized by hyperinflammation, acute respiratory distress syndrome (ARDS), and hypercoagulability. A 68-year-old man with coronavirus disease 2019 (COVID-19) was admitted to the intensive care unit with respiratory failure, cytokine release syndrome (CRS), and skin ischemia - microthrombosis. Specific coagulation and inflammatory markers (D-dimer, ferritin, and C-reactive protein), along with the clinical picture, triggered the trial of recombinant tissue plasminogen activator (rt-PA) and tocilizumab. This was followed by resolution of the skin ischemia and CRS, while respiratory parameters improved. No major complications associated with rt-PA or tocilizumab occurred. The combination of rt-PA with targeted anti-inflammatory treatment could be a new therapeutic option for patients with COVID-19, ARDS, hyperinflammation, and increased blood viscosity.
Identifiants
pubmed: 32497796
pii: S1201-9712(20)30425-2
doi: 10.1016/j.ijid.2020.05.118
pmc: PMC7263262
pii:
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Drug Combinations
0
Fibrinolytic Agents
0
Immunosuppressive Agents
0
Tissue Plasminogen Activator
EC 3.4.21.68
tocilizumab
I031V2H011
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
90-93Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Références
Cell Mol Immunol. 2016 Jul;13(4):432-42
pubmed: 27041635
Eur J Case Rep Intern Med. 2020 Apr 08;7(5):001646
pubmed: 32399449
Thromb Haemost. 2020 May;120(5):876-878
pubmed: 32246450
Eur Heart J. 2020 May 14;41(19):1858
pubmed: 32227120
Thromb Haemost. 2001 Nov;86(5):1327-30
pubmed: 11816725
Res Pract Thromb Haemost. 2020 Jun 09;4(4):518-523
pubmed: 32542212
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452
Proc Natl Acad Sci U S A. 2020 May 19;117(20):10970-10975
pubmed: 32350134
Arthritis Rheumatol. 2014 Sep;66(9):2613-20
pubmed: 24782338
Am J Hematol. 2020 Jul;95(7):834-847
pubmed: 32282949
J Trauma Acute Care Surg. 2020 Jun;88(6):713-714
pubmed: 32281766
Pharmacotherapy. 2007 Jun;27(6):860-73
pubmed: 17542769
J Thromb Haemost. 2020 May;18(5):1094-1099
pubmed: 32220112