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Management of Adults with COVID-19
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Two recent trials suggest that immune-damping drugs such as tocilizumab may reduce mortality in patients with severe COVID-19.
Early in the COVID-19 pandemic, researchers believed severely ill patients had cytokine storm, leading them to propose the use of existing antiinflammatory drugs that damp the immune system, such as tocilizumab. Although we have since learned that levels of inflammation are lower in COVID-19 patients than in other severely ill patients (such as those with sepsis or acute respiratory distress syndrome), research into these immune-damping drugs had already begun. While early results were mixed, two recent trials are more promising, suggesting that these drugs may reduce mortality in patients with severe COVID-19. But, as with all therapies used to treat COVID-19, there are qualifiers, including the patient population most likely to benefit, rapid dissemination of results in preprint form, and a paucity of long-term follow-up.
“Ultimately, the early data suggest that tocilizumab may be a new option to treat COVID-19 patients who are rapidly deteriorating or have more severe forms of inflammation, such as very elevated C-reactive protein,” said Greg S. Martin, MD, MSc, FCCM, professor of pulmonary and critical care medicine at Emory University and president of SCCM. “While it is impossible to make a definitive recommendation at present, it appears most beneficial when given to patients within 24 to 48 hours of hospitalization.”
Posted: 2/19/2021 | 0 comments
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