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      Weather the Cytokine Storm: A Report of Successful Management of a Colon Cancer Survivor and a Critically Ill Patient with COVID-19

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          Abstract

          Patients with novel corona virus infection (COVID-19) can develop acute respiratory failure secondary to acute respiratory distress syndrome. Cytokine storm is suggested as one of underlying mechanisms for the rapid clinical decline. Immunocompromised patients and cancer patients are at particular risk for poor outcomes due to COVID-19 infection. This case report describes the presentation and clinical course of a cancer survivor who became critically ill and required mechanical ventilation. The patient was treated with hydroxychloroquine, azithromycin, and ceftriaxone; however, he remained febrile, hypoxemic, continued to require full mechanical ventilator support and his chest X-ray showed increased bilateral infiltrates. The patient was treated with tocilizumab, after which he improved and was successfully extubated. This report illustrates a possible role of tocilizumab in management of cytokine storm in critically ill patients with COVID-19 infection.

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          Most cited references 1

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          Rapid review for the anti-coronavirus effect of remdesivir.

          The outbreak of SARS-CoV-2 rapidly spread across China and worldwide. Remdesivir had been proposed as a promising option for treating coronavirus disease 2019 (COVID-19). We provided a rapid review to critically assess the potential anti-coronavirus effect of remdesivir on COVID-19 and other coronaviruses based on the most up-to-date evidence. Even though remdesivir was proposed as a promising option for treating COVID-19 based on laboratory experiments and reports from compassionate use, its safety and effect in humans requires high-quality evidence from well-designed and adequately-powered clinical trials for further clarification.
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            Author and article information

            Journal
            CRO
            CRO
            10.1159/issn.1662-6575
            Case Reports in Oncology
            S. Karger AG
            1662-6575
            2020
            May – August 2020
            29 June 2020
            : 13
            : 2
            : 754-759
            Affiliations
            aMercy Hospital, Oklahoma City, Oklahoma, USA
            bJohnston Memorial Hospital, Ballad Health System, Abingdon, Virginia, USA
            cDivision of Hematology/Oncology, Augusta University, Augusta, Georgia, USA
            Author notes
            *Dr. Mansoor Khalid, MD, Mercy Hospital, Oklahoma City, OK 73120 (USA), mansoor.khalid@mercy.net
            Article
            509507 PMC7360508 Case Rep Oncol 2020;13:754–759
            10.1159/000509507
            PMC7360508
            32774271
            © 2020 The Author(s). Published by S. Karger AG, Basel

            This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 2, Pages: 6
            Product
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/509507
            Categories
            Case Report

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