Tocilizumab in Severe COVID-19 Pneumonia and Concomitant Cytokine Release Syndrome

Authors

• Tom van Kraaij Department of Pulmonology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
• Rémy Mostard Department of Pulmonology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
• Sofia Ramiro Department of Rheumatology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
• Cesar Magro Checa Department of Rheumatology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
• Christel van Dongen Department of Rheumatology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
• Eric HJ van Haren Department of Pulmonology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
• Jacqueline Buijs Department of Internal Medicine, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands
• Robert Landewé Department of Rheumatology, Zuyderland Medical Center, Heerlen-Sittard, the Netherlands; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands

t.vankraaij@zuyderland.nl

Keywords

Abstract

Younger patients with COVID-19 may experience an exaggerated immune response to SARS-CoV-2 infection and develop cytokine release syndrome (CRS), which may be life threatening. There is no proven antiviral therapy for COVID-19 so far, but profound immunosuppression has recently been suggested as a treatment for COVID-19-associated CRS. We present a case of life-threatening CRS caused by COVID-19 infection with a favourable response to immunosuppressive therapy with tocilizumab (TCZ). The rapid clinical and biochemical improvement following TCZ administration suggests that treatment with immunotherapy can be life-saving in selected patients with COVID-19-induced CRS.