Background: Coronavirus disease 2019 (COVID-19) is a pandemic caused by a novel beta coronavirus severe acute respiratory syndrome coronavirus (SARS-CoV-2). The symptoms range from mild to severe in nature. The severity of respiratory symptoms is due to the cytokine storm. The tocilizumab, interleukin-6 inhibitor, can prevent the cytokine release and decrease the mortality. Patients and methods: This is a retrospective observational study of 20 COVID-19 positive cases who received tocilizumab. Results and conclusion: There were 75% males with a mean age of 47.20±9.68 years in our study. 50% had diabetes mellitus, 35% had hypertension, 5% had Chronic kidney disease, 5% had obesity and 5% had hypothyroidism. Mortality was reduced to 65% with tocilizumab administration. There was statistically significant reduction of C- reactive protein (p<0.00052) and IL-6 (interleukin) (p<0.023) after administration of tocilizumab. Keywords: tocilizumab; interleukin-6; COVID-19; C-reactive protein
Background: Acute leukemia in pregnancy is estimated to occur in less than one in one lakh pregnancies. Management of these patients differs by the trimester in which they present, because of the differential sensitivity of the fetus to chemotherapy during the three trimesters. Because of the rarity of this situation, there is scarcity of data on the management of these patients. Materials and method: We included patients with acute leukemia diagnosed and treated during pregnancy at our institute and reviewed 3 successive patients for this case series. Results and conclusion: Acute leukemia in pregnancy presents a unique challenge for treatment and requires multidisciplinary co-ordination for treatment. When judiciously managed, good outcomes of disease of mother and fetus can be achieved. Our three patients included one in each trimester; the first trimester patient underwent medical termination of pregnancy and has successfully completed treatment. The second trimester patient underwent induction chemotherapy and delivered a healthy baby. The patient diagnosed in the third trimester delivered a pre-term healthy baby during treatment and continues to be on chemotherapy.
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