The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19: Single Centered Experience Case series
One of the main causes of death in COVID-19 is the dysregulation of the host’s immune system which leads to cytokine storm, a potentially fatal systemic inflammatory syndrome. Interleukin 6 (IL-6) is a pro-inflammatory cytokine that is produced in response to infections and tissue injuries and is be...
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| Format: | Article |
| Language: | English |
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Interna Publishing
2021-10-01
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| Series: | Acta Medica Indonesiana |
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| Online Access: | http://www.actamedindones.org/index.php/ijim/article/view/1854 |
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| author | Eric Daniel Tenda Setiabakti Andrian Sedjahtera Albert Moses M Asaf Ceva W Pitoyo Siti Setiati Imam Subekti |
| author_facet | Eric Daniel Tenda Setiabakti Andrian Sedjahtera Albert Moses M Asaf Ceva W Pitoyo Siti Setiati Imam Subekti |
| author_sort | Eric Daniel Tenda |
| collection | DOAJ |
| description | One of the main causes of death in COVID-19 is the dysregulation of the host’s immune system which leads to cytokine storm, a potentially fatal systemic inflammatory syndrome. Interleukin 6 (IL-6) is a pro-inflammatory cytokine that is produced in response to infections and tissue injuries and is believed to play a pivotal role in the event of a cytokine storm, as signified by its increase in the process. Considering the role of IL-6 as a pro-inflammatory cytokine in the process of cytokine storm in COVID-19, perceiving IL-6 as a therapeutic target could prove to be promising. Tocilizumab is a monoclonal antibody that competitively inhibits the binding of IL-6 to its receptor (IL-6R). The use of IL-6R blocker is recommended for severe COVID-19 patients in the latest therapeutic guideline published by the World Health Organization (WHO), but the timing of the administration has not been specified. While previous studies about the use of tocilizumab in COVID-19 patients have shown various results, these studies do not emphasize on plasma IL-6 levels when deciding the time of tocilizumab administration. In this case series, we present three patients with moderate to severe COVID-19 infections that receive tocilizumab as an adjunct to the standard of care therapy. This case series introduces the novel idea that the timely use of tocilizumab as signified by plasma IL-6 levels in moderate to severe COVID-19 patients could potentially improve overall clinical condition and increase survival rate. |
| format | Article |
| id | doaj-art-6ac07e928d7a48bb890d372f12e4a579 |
| institution | Matheson Library |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj-art-6ac07e928d7a48bb890d372f12e4a5792025-07-14T07:01:31ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322021-10-01533The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19: Single Centered Experience Case seriesEric Daniel Tenda0Setiabakti Andrian1Sedjahtera Albert2Moses M Asaf3Ceva W Pitoyo4Siti Setiati5Imam Subekti6Division of Respirology and Critical Care, Departement of Internal Medicine, Universitas Indonesia. Dr Cipto Mangunkusumo National General Hospital. Imperial College London.Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - CEEBM Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Endocrine Metabolic and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - COVID-19 Board Cipto Mangunkusumo Hospital, Jakarta, IndonesiaOne of the main causes of death in COVID-19 is the dysregulation of the host’s immune system which leads to cytokine storm, a potentially fatal systemic inflammatory syndrome. Interleukin 6 (IL-6) is a pro-inflammatory cytokine that is produced in response to infections and tissue injuries and is believed to play a pivotal role in the event of a cytokine storm, as signified by its increase in the process. Considering the role of IL-6 as a pro-inflammatory cytokine in the process of cytokine storm in COVID-19, perceiving IL-6 as a therapeutic target could prove to be promising. Tocilizumab is a monoclonal antibody that competitively inhibits the binding of IL-6 to its receptor (IL-6R). The use of IL-6R blocker is recommended for severe COVID-19 patients in the latest therapeutic guideline published by the World Health Organization (WHO), but the timing of the administration has not been specified. While previous studies about the use of tocilizumab in COVID-19 patients have shown various results, these studies do not emphasize on plasma IL-6 levels when deciding the time of tocilizumab administration. In this case series, we present three patients with moderate to severe COVID-19 infections that receive tocilizumab as an adjunct to the standard of care therapy. This case series introduces the novel idea that the timely use of tocilizumab as signified by plasma IL-6 levels in moderate to severe COVID-19 patients could potentially improve overall clinical condition and increase survival rate.http://www.actamedindones.org/index.php/ijim/article/view/1854case seriesCOVID-19interleukin-6timelytocilizumab |
| spellingShingle | Eric Daniel Tenda Setiabakti Andrian Sedjahtera Albert Moses M Asaf Ceva W Pitoyo Siti Setiati Imam Subekti The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19: Single Centered Experience Case series Acta Medica Indonesiana case series COVID-19 interleukin-6 timely tocilizumab |
| title | The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19: Single Centered Experience Case series |
| title_full | The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19: Single Centered Experience Case series |
| title_fullStr | The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19: Single Centered Experience Case series |
| title_full_unstemmed | The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19: Single Centered Experience Case series |
| title_short | The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19: Single Centered Experience Case series |
| title_sort | importance of the timing of tocilizumab administration in moderate to severely ill covid 19 single centered experience case series |
| topic | case series COVID-19 interleukin-6 timely tocilizumab |
| url | http://www.actamedindones.org/index.php/ijim/article/view/1854 |
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