The 42-year-old man arrived at a hospital in Paris on March 17 with a fever, cough and the “ground glass opacities” in both lungs that are a trademark of infection with the new coronavirus.
Two days later, his condition suddenly worsened and his oxygen levels dropped. His body, doctors suspected, was in the grip of a cytokine storm, a dangerous overreaction of the immune system. The phenomenon has become all too common in the coronavirus pandemic, but it is also pointing to potentially helpful drug treatments.
In some cases — as much as 15 percent of people battling any serious infection, according to Dr. Cron’s team — the immune system keeps raging long after the virus is no longer a threat. It continues to release cytokines that keep the body on an exhausting full alert. In their misguided bid to keep the body safe, these cytokines attack multiple organs including the lungs and liver, and may eventually lead to death.
His doctors tried tocilizumab, a drug they have sometimes used to soothe an immune system in distress. After just two doses of the drug, spaced eight hours apart, the patient’s fever rapidly disappeared, his oxygen levels rose and a chest scan showed his lungs clearing. The case report, described in an upcoming paper in Annals of Oncology, joins dozens of accounts from Italy and China, all indicating that tocilizumab might be an effective antidote to the coronavirus in some people.
Encouraging news and great explanation about how the cytokine storm worked! I've had ground glass opacities with pneumonia several times and my family doctor didn't give me any explanation about it when I asked her. I've always wondered why and how this worked.
Thanks so much for this Jackie. A member here... Strickland ... Yesterday posted a thought/question about individual immune system responses affecting the viruses development..
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Later PS : My post above to you, Jackie, was sent before I saw a reply Strickland had already sent me. Although his original posting was interesting, I would like to say that I do not support the views he further holds or respect the article in the Mail that he finds worthy.
I believe that this is one of the drugs being used off label with results carefully monitored in the US. I don’t know that there is an official trial design here yet, but hope that there is enough of this drug available to use while doctors work to unravel the inner workings of this virus. I wonder whether they will find that different of these off label used drugs will affect patients positively depending on where they are with the virus. Will one be indicated for someone newly diagnosed but without extreme symptoms, whereas another, maybe this one, will be saved for patients exhibiting symptoms of a cytokine storm? There is so much to learn and we need to know it by yesterday!
I hope this drug can be the one. There are so many people that enjoy spontaneous recoveries with covid, it’s just so hard to know if it’s some drug they have been given or if the virus just ran it’s course.
To my understanding there are many clinical trials going on with many drugs which have had anecdotal success. Who knows which drug turns out to be the one? It could be tocilizumab. At least it has some known mechanism of action with reducing cytokine inflammation.
Hope they can figure out which people it's going to work for, and make enough of the stuff. Also make an alternative for those it's not going to work on.
Jackie, I've just re-read this NY times article you posted. It's really such a clear and beautifully written piece.
Bearing in mind you posted this two weeks ago, why exactly has there been so much excitement about Aclabrutinib (outside of our community)? Do you know if the medics treating Covid patients with Aclabrutinib mentioned any better or quicker recovery than those treating with Tocilizumab?? Or is the Calquence excitement mostly due to Astra Zeneca,'s PR?
I think it's just too early to say anything with any certainty. These treatments are being tried based on the theoretical benefit derived from their mechanism of action.
There are plenty of clinical trials going on and in the UK more than 5,000 patient have been entered into a variety of COVID19 studies. Sadly, this has been to the disadvantage of other clinical trials in development or early stages.
If I become aware of anything then I will definitely post.
OK. I thought the interest was initially generated by numerous anecdotal reports from Doctors treating Covid patients in intensive care. So that's what I was referring to. Anyway, point taken, we'll wait to hear.
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