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Experience with the use of recombinant humanized monoclonal antibodies to the human receptor for interleukin-6 in patients with CoVID-19

https://doi.org/10.22625/2072-6732-2020-12-3-28-33

Abstract

The new coronavirus infection (COVID-19) has become a truly global challenge for all of humanity, and, above all, for the healthcare system. Among its most important aspects requiring careful analysis are the clinical and laboratory features of the course of the disease, which make it possible to determine approaches to pathogenetic therapy in severe forms of the disease.
Materials and methods. A retrospective analysis of medical records of patients (n = 31) of severe COVID-19 patients who were hospitalized in St. Petersburg City Clinical Hospital for Infectious Diseases named after S.P. Botkin ”in March – May 2020. Clinical and laboratory characteristics were evaluated, including the level of ferritin, C-reactive protein, D-dimer, interleukin-6, depending on the severity of the disease. The criteria for the appointment of a recombinant humanized monoclonal antibody to the human receptor for interleukin-6 (INN – tocilizumab) in patients with a severe course of the disease and its effectiveness are determined.
Results. In the treatment of severe patients with COVID-19, it is necessary to carefully evaluate the clinical picture of the course of the disease, which may be ahead of changes in laboratory parameters. The introduction of tocilizumab leads to a rapid regression of general infectious symptoms, subjective and objective manifestations of respiratory failure and, as a consequence, a decrease in the duration of hospitalization. It is extremely important that the drug is administered in a timely manner during the rise of the “cytokine storm”. The time for optimal administration of tocilizumab begins from 8-9 days from the onset of the disease, until the patient is transferred to mechanical ventilation.

About the Authors

D. А. Gusev
National Medical Research Centre named after V.A. Almazov; Clinical Infectious Hospital named after S.P. Botkin
Russian Federation
Saint-Petersburg


М. А. Vashukova
Clinical Infectious Hospital named after S.P. Botkin
Russian Federation
Saint-Petersburg


I. P. Feduniak
Clinical Infectious Hospital named after S.P. Botkin; North-Western State Medical University named after I.I. Mechnikov
Russian Federation
Saint-Petersburg


V. B. Musatov
Clinical Infectious Hospital named after S.P. Botkin; Saint-Petersburg State University
Russian Federation
Saint-Petersburg


V. A. Kapatsyna
Clinical Infectious Hospital named after S.P. Botkin
Russian Federation
Saint-Petersburg


References

1. Pshenichnaya N.YU. COVID-19 – Novaya global’naya ugroza chelovechestvu / N.YU. Pshenichnaya, E.I. Veselova, D.A. Semenova. S.S. Ivanova, A.S. ZHuravlev // Epidemiologiya i infekcionnye bolezni. Aktual’nye voprosy – 2020. – №1. – S. 6-13.

2. Zhao Y., Zhao Z., Wang Y., Zhou Y., Ma Y., Zuo W. Singlecell RNA expression profiling of ACE2, the putative receptor of Wuhan 2019-n-Cov. bioRxiv. 2020 Jan 28. Available from: http://doi.org/10.1101/2020.01.26.919985

3. Amdahl M. Covid-19:Debunking the Hemoglobin Story Available from: https:/medium.com/@amdahl/covid-19debunking-thehemoglobin-story-ce27773d1096

4. Liu W., Li H. COVID-19: Attacks the 1-beta Chain of Hemoglobin and Captures the Porhyrin to Inhibit Heme Metabolism. Available from: https://doi.org/10.26434/chemrxiv.11938173.v8

5. Xiao F., Tang M., Zheng X.et al. Evidence for gastrointestinal infection of SARS-CoV-2 Gastroenterology. 2020. Available from: https://doiorg/10.1053/j.gastro.2020.02.055

6. Hua S., Ming Y., Cheng W. et al. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney International. 2020 Available from: https://doiorg/10.1016/j.kint.2020.04.003

7. Xie Z., Lin Y., Chen Y. Analysis of clinical characteristics of severe and critically ill influenza A (H1N1). J. Biomed. Sc. 2019;(26)84

8. Vremennye metodicheskie rekomendacii «Profilaktika, diagnostika i lechenie novoj koronavirusnoj infekcii (COVID-19). Versiya 7 (03.06.2020)» // Ministerstvo zdravoohraneniya rossijskoj Federacii. 2020. – 165 s.

9. Wichmann D., Sperhake J., Litgehetmann M. et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19. Annals org. published. 2020;(0):5 Available from: https://doiorg/10.7326/M20-2003

10. Varga S., Flammer A.J., Steiger P. et al. Endothelial cell infection and endotheliitis in CoVID-19. The Lancet Pulished online. 2020 Available from: https://doiorg/10.106/S0140-6736(20)30937-5

11. Shoenfeld Y. Corona (COVID-19) time musings: our invovement in COVID-19 pathogenesis, diagnosis, treatment ande vaccine planning. Autoimmunity reviews article in press. Available from: https://doi.org/10.1016/j.autrev.2020.102538

12. Cinzerling V. A. Voprosy patomorfogeneza novoj koronavirusnoj infekcii (COVID-19) / V.A. Cinzerling, M.A. Vashukova, M.V. Vasil’eva, A.N. Isakov i dr. // ZHurnal infektologii. – 2020. –T.2. – S.5-11

13. Vremennye metodicheskie rekomendacii “Profilaktika, diagnostika i lechenie novoj koronavirusnoj infekcii (COVID-19). Versiya 6 (28.04.2020)» // Ministerstvo zdravoohraneniya rossijskoj Federacii. 2020. – 157 s.

14. Lui T., Zhang J., Yang Y., et al. The potential role of IL-6 in monitoring severe case of coronavirus disease 2019. medRxiv. 2020. Available from: doi: https://doi.org/10.1101/2020.03.01.20029769

15. Wu C., Chen X., Cai Y., et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in wuhan, china. JAMA. Intern Med. 2020.

16. Ruan Q., Yang K., Wang W., Jiang L., Song J. Clinical predictors of mortality due to COVID 19 based on an analysis of data of 150 patients from Wuhan, china. Intensive Care Med. 2020

17. Ni Y.N., Chen G., Sun J., Kiang B.M., Liang Z.A., Ni Y.N. The effect of corticosteroids on mortality of patients with influenza pneumonia: a systematicreview ahd meta-analysis Available from: ccforun.biomedcentral.com/articles/10.1186/s13054-019-2395-8


Review

For citations:


Gusev D.А., Vashukova М.А., Feduniak I.P., Musatov V.B., Kapatsyna V.A. Experience with the use of recombinant humanized monoclonal antibodies to the human receptor for interleukin-6 in patients with CoVID-19. Journal Infectology. 2020;12(3):28-33. (In Russ.) https://doi.org/10.22625/2072-6732-2020-12-3-28-33

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ISSN 2072-6732 (Print)