Ovilla-Martínez R, De la Peña-Celaya JA, Báez-Islas PE, Del Bosque-Patoni C, Guzmán-Bouilloud NE, Rodríguez-Sandoval R, Cota-Rangel X

Language: Spanish
References: 8
Page: 740-744
PDF size: 421.37 Kb.

ABSTRACT

Background: The pulmonary changes in COVID-19 are associated with cytokine release syndrome that could be treated with JAK inhibitors through the blockade of type I interferon and IL-6, IL-1, TNF and GM-CSF.
Clinical case: A 32-year-old female with previous iron-deficiency anemia. She presented cough, tachypnea, fever, diarrhea and low oxygen saturation to 86% by pulse oximeter. PCR for SARS-CoV-2 was reported positive and bilateral pneumonia was seen on CT-scan. Diagnosis of COVID-19 pneumonia was confirmed. At diagnosis with erythrocyte sedimentation rate (ESR) 33 mm/hour, CRP 8.4 mg/dL, LDH 317 U/L, DD 412 ng/mL, lymphocytes 0.8 x 10³/µL, hemoglobin 7.4 g/dL with rest of bloodcount being normal. Ruxolitinib at 5 mg BID for 14 days was given. The patient was discharged after 7 days of hospital-length without supplemental oxygen and improvement in CT-scan and proinflammatory values: ESR 18 mm/hour, CPR 0.7 mg/mL, LDH 187 U/L, DD 308 ng/dL, lymphocytes 1.8 x 10³/µL, hemoglobin 11.4 g/dL.
Conclusions: Ruxolitinib proved to be a safe and efficient treatment for SARS-CoV-2 pneumonia with limitation of the cytokine release syndrome demonstrated by clinical evolution and proinflammatory markers.

REFERENCES

1. Coronavirus disease (COVID-19) pandemic. [citado 2020 Jun 1] Disponible en: https://www.who.int/emergencies/ diseases/novel-coronavirus-2019. Coronavirus (COVID- 19) – Comunidado Técnico Diario. [citado 2020 Jun 1] Disponible en: https://www.gob.mx/salud/documentos/ coronavirus-covid-19-comunicado-tecnico-diario

2. Therapeutic Options Under Investigation | Coronavirus Disease COVID-19. [citado 2020 May 5]. Disponible en: https://covid19treatmentguidelines.nih.gov/therapeuticoptions- under-investigation/

3. Li G, Fan Y, Lai Y, et al. Coronavirus infections and immune responses. J Med Virol 2020; 92 (4): 424-432.

4. Verstovsek S, Kantarjian H, Mesa RA, et al. Safety and efficacy of INCB018424, a JAK1 and JAK2 inhibitor, in myelofibrosis. N Engl J Med 2010; 363 (12): 1117-1127. DOI: 10.1056/NEJMoa1002028

5. Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020; 130 (5): 2620-2629.

6. Merad M, Martin JC. Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol 2020; 20: 355-362.

7. Jakafi (ruxolitinib) dosing, indications, interactions, adverse effects, and more [citado 2020 May 26]. Disponible en: https://reference.medscape.com/drug/jakafiruxolitinib- 999703

8. Coronavirus, Hospedale di Livorno, primi esiti positivi in pazienti trattati con farmaco “antiterapie intensive” | Città di Livorno [citado 2020 Abr 1]. Disponible en: http://www.comune.livorno.it/articolo/coronavirusospedale- livorno-primi-esiti-positivipazienti-trattatifarmaco- anti-terapie