介绍-COVID-19是一种大流行性疾病,主要影响呼吸道,引发炎症级联反应并伴有多器官衰竭直至死亡。在这种疾病的测试药物中,托珠单抗似乎直接作用于炎症级联反应,改善COVID-19结果。出于这个原因,我们使用胸部计算机断层扫描(CT)测试了托珠单抗对肺损伤的疗效.病例介绍:该研究是在2020年3月至6月期间对21名住院的COVID-19患者进行的。根据施用的疗法将患者分为2组(TCZ组=使用托珠单抗治疗,NTZ组=其他疗法)。入院时,TCZ组的实验室测试值较差,呼吸曲线(PaO2/FiO2比值:145.37±38.16mmHgvsNTZ组257.9±95.3mmHg,P<0.01)和放射学征象(胸部X线多焦混浊:NTZ组88%vs23%,P<0.01)。在临床恢复时进行胸部CT检查后,比较了两组的扫描结果,我们观察到一些特征(例如,毛玻璃不透明度,巩固和实质带)在TCZ组中较少。结论-在我们的研究中,接受托珠单抗治疗的患者在入院时的总体临床和放射学特征较差,但对照CT显示与接受标准治疗的患者相似的影像学表现.根据这些证据,我们可能提示托珠单抗在减轻COVID-19患者肺部炎症中起重要作用.
COVID-19 is a pandemic disease, mainly affecting the respiratory tract, triggering an inflammatory cascade complicated by multiorgan failure up to death. Among the tested medications for this disease, tocilizumab appears to act directly on the inflammatory cascade, improving COVID-19 outcomes. For this reason, we have tested the efficacy of tocilizumab on lung damage using chest computed tomography (CT).
The study was conducted on twenty-one hospitalised COVID-19 patients between March-June 2020. Patients were divided into 2 groups according to the therapies administered (TCZ group= treatment with tocilizumab and NTZ group= other therapies). At admission, TCZ group presented worse laboratory test values, respiratory profile (PaO2/FiO2 ratio: 145.37±38.16 mmHg vs 257.9±95.3 mmHg of NTZ group, P<0.01) and radiological signs (multifocal opacity at chest-X-ray: 88% vs 23% of NTZ group, P<0.01). After performing chest CT during the clinical recovery, the scans of the 2 groups were compared and we observed that some features (e.g., ground glass opacity, consolidation and parenchymal bands) were less marked in the TCZ group.
In our study, patients treated with tocilizumab presented a worse overall clinical and radiological profile at admission, but the control CT showed a similar imaging profile to patients treated with standard therapy. Based on this evidence, we may suggest that tocilizumab plays an important role in COVID-19 patients in reducing lung inflammation.