Sarilumab administration in patients with severe COVID‑19: A report of four cases and a literature review

Marino, Andrea; Campanella, Edoardo; Ceccarelli, Manuela; Larocca, Licia; Bonomo, Carmelo; Micali, Cristina; Munafò, Antonio; Celesia, Benedetto Maurizio; Nunnari, Giuseppe; Cacopardo, Bruno

doi:10.3892/wasj.2022.159

Cited by 6 publications

(6 citation statements)

References 30 publications

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“…There is evidence that individuals with an early hyperinflammatory phenotype and organ damage in the second week following the beginning of symptoms may benefit primarily from inhibiting the IL-6 in terms of treating this sort of excessive inflammatory response in COVID-19. Findings that increased IL-6 levels are associated with lymphopenia: a larger viral load, hypoxemia, systemic inflammation, and a worse prognosis lend credence to the important involvement of IL-6 in the pathogenesis of SARS-CoV-2 infection [ 117 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to case series research conducted by Marino et al (2022), the recombinant human monoclonal antibody Sarilumab, which is intended to suppress IL-6, may be used to treat COVID-19. The clinical and biochemical circumstances of these individuals started to become better, according to research, up until the O 2 therapy was stopped and they were discharged [ 117 ]. In cells that expressed the IL-6 membrane receptor (mIL-6R) and glycoprotein (gp)130, sarilumab inhibits the effects of IL-6.…”

Section: Discussionmentioning

confidence: 99%

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Hyperinflammatory Response in COVID-19: A Systematic Review

Silva

Ribeiro

Gouveia

et al. 2023

Viruses

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COVID-19 is a multisystemic disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The immunopathogenic conditions of the hyperinflammatory response that cause systemic inflammation are extremely linked to its severity. This research sought to review the immunopathological elements that contribute to its progression. This is a systematic review using the PUBMED, LILACS, MEDLINE, and SCIELO databases using articles between May 2020 and July 2022 with the following search terms in conjunction with “AND”: “SARS-CoV-2”; “COVID-19”; “ARDS” and “Cytokine Storm”. The quality appraisal and risk of bias were assessed by the JBI checklists and the Cochrane Collaboration’s RoB 2.0 and ROBINS-I tools, respectively, and the risk of bias for in vitro studies by a pre-defined standard in the literature. The search resulted in 39 articles. The main actors in this response denote SARS-CoV-2 Spike proteins, cellular proteases, leukocytes, cytokines, and proteolytic cascades. The “cytokine storm” itself brings several complications to the host through cytokines such as IL-6 and chemokines (such as CCL2), which influence tissue inflammation through apoptosis and pyroptosis. The hyperinflammatory response causes several unfavorable outcomes in patients, and systemic inflammation caused largely by the dysregulation of the immune response should be controlled for their recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hyperinflammatory Response in COVID-19: A Systematic Review

Silva

Ribeiro

Gouveia

et al. 2023

Viruses

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“…The SARS-CoV-2 pandemic (19) may have contributed to an increase the number of cases with VAP, due to the large number of affected patients requiring ICU care and mechanical ventilation (20).…”

Section: Discussionmentioning

confidence: 99%

Management of ventilator‑associated pneumonia due to Stenotrophomonas maltophilia infection: A case report and literature review

et al. 2023

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Stenotrophomonas maltophilia (S. maltophilia) is a difficult-to-treat bacteria. This glucose non-fermenting, multidrug-resistant Gram-negative bacillus is known to cause a range of infections, such as skin manifestations and bacteraemia, with respiratory tract infections being the most common. Patients in intensive care units are often exposed to a higher risk of acquiring an infection caused by this pathogen. Although distinguishing between S. maltophilia infections and colonization can be challenging, pneumonia caused by S. maltophilia infection is becoming increasingly prevalent. Furthermore, S. maltophilia infections are often coupled with Pseudomonas aeruginosa infections, reinforcing the need to consider this bacterium as a potential cause of ventilator-associated pneumonia (VAP). The present study describes the case of a 66-year-old male who was diagnosed with VAP due to S. maltophilia infection. This condition was effectively treated with trimethoprim/sulfamethoxazole. The case described herein underscores the importance of prompt recognition through heightened clinical suspicion, particularly in patients with VAP who are unresponsive to broad-spectrum β-lactam antibiotics. The early identification of S. maltophilia as the root cause of respiratory tract infections can make a significant difference to the outcomes of affected patients.

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“…Among bacterial and viral superinfections [ 22 , 23 , 24 ], COVID-19 has been widely associated with mucormycosis through several pathological patterns such as immune system impairment due to cytokine storm [ 25 ], impaired phagocytosis, and endothelitis [ 26 , 27 ]. In addition, immunosuppressive therapies such as corticosteroids and immunomodulatory therapies such as anti-IL6 antibodies favor the development of COVID-19 associated mucormycosis (CAM) [ 28 , 29 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Mucorales/Fusarium Mixed Infection in Hematologic Patient with COVID-19 Complications: An Unfortunate Combination

et al. 2023

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Hematological diseases, especially those causing severe neutropenia, represent the main factor in the development of invasive fungal infections (IFIs). Furthermore, COVID-19 has been considerably associated with IFIs due to immunological dysregulation, prolonged hospitalization in intensive care units, and immunomodulatory therapies. Opportunistic molds are correlated with elevated morbidity and mortality rates in these patients, due to immune impairment, diagnostic complexity, and therapeutic challenges. Among opportunistic fungal infections, the Mucorales and Fusarium species are considered particularly aggressive, especially during severe neutropenia. A mixed Mucorales/Fusarium infection has been rarely described in scientific literature. Herein, we report a case of Mucorales and Fusarium co-infection in a patient with acute leukemia whose clinical history was also complicated by COVID-19. Herein, we report a challenging case in order to encourage the clinical suspicion of combined fungal infections in immunosuppressed patients, performing a punctual microbiological diagnosis, and promptly administering the correct empiric and targeted antifungal therapy.

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Sarilumab administration in patients with severe COVID‑19: A report of four cases and a literature review

Cited by 6 publications

References 30 publications

Hyperinflammatory Response in COVID-19: A Systematic Review

Hyperinflammatory Response in COVID-19: A Systematic Review

Management of ventilator‑associated pneumonia due to Stenotrophomonas maltophilia infection: A case report and literature review

Mucorales/Fusarium Mixed Infection in Hematologic Patient with COVID-19 Complications: An Unfortunate Combination

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