CHRISTINE A. CANNON, PH.D. (FAMILY STUDIES), RNf JOHN C. CAVANAUGH, PH.D. (PSYCHOLOGY)*This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Couples in which one spouse has chronic obstructive airway disease (COAD) face great distress and change over the life course. Couples experience multiple losses and feelings of anxiety, depression and hopelessness, usually beginning in mid-life and continuing into older age. This study explored two sources of social support - family support and friend support - as resources for coping with illness. The relation of family and friend received and provided support with marital satisfaction and the effects of sex and length of marriage were studied. Results indicated that the association between support and marital satisfaction was moderated by the couple's length of marriage, the sex of patients and spouses, and the degree of congruency between husbands' and wives' evaluations of their marital satisfaction. Support acted as a stress buffer in regard to marital satisfaction only for male spouses and male patients. Implications for theory, research and preventive interventions are discussed.

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Aim: To describe the first Australian cases of severe acute respiratory syndromecoronavirus 2 (SARS-CoV2) disease (COVID-19) pneumonia treated with the interleukin-6 receptor antagonist tocilizumab. Methods: Retrospective, open-label, real-world, uncontrolled, single-arm case series conducted in 2 tertiary hospitals in NSW, Australia and 1 tertiary hospital in Victoria, Australia. Five adult male patients aged between 46 and 74 years with type 1 respiratory failure due to COVID-19 pneumonia requiring intensive care unit (ICU) admission and biochemical evidence of systemic hyperinflammation (C-reactive protein greater than 100 mg/L; ferritin greater than 700 μg/L) were administered variabledose tocilizumab. Results: At between 13 and 26 days follow-up, all patients are alive and have been discharged from ICU. Two patients have been discharged home. Two patients avoided endotracheal intubation. Oxygen therapy has been ceased in three patients. Four adverse events potentially associated with tocilizumab therapy occurred in three patients: ventilator-associated pneumonia, bacteremia associated with central venous catheterization, myositis and hepatitis. All patients received broad-spectrum antibiotics, 4 received corticosteroids and 2 received both lopinavir/ritonavir and hydroxychloroquine. The time from first tocilizumab administration to improvement in ventilation, defined as a 25% reduction in fraction of inspired oxygen required to maintain peripheral oxygen saturation greater than 92%, ranged from 7 hours to 4.6 days. Conclusions: Tocilizumab use was associated with favorable clinical outcome in our patients. We recommend tocilizumab be included in randomized controlled trials of treatment for patients with severe COVID-19 pneumonia, and be considered for compassionate use in such patients pending the results of these trials. | 1031 WEST ET al.

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