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Combination of thrombolytic and immunosuppressive therapy for coronavirus disease 2019: A case report

2020; Elsevier BV; Volume: 97; Linguagem: Inglês

10.1016/j.ijid.2020.05.118

1878-3511

Panagiotis Papamichalis, Antonio Artigas, Periklis Katsiafylloudis, Apostolia-Lemonia Skoura, Michail Papamichalis, Evangelia Neou, D. Papadopoulos, Spyridon Karagiannis, Tilemachos Zafeiridis, Dimitris Babalis, A. Komnos,

Long-Term Effects of COVID-19

In a proportion of patients, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a multisystem syndrome characterized by hyperinflammation, acute respiratory distress syndrome (ARDS), and hypercoagulability. A 68-year-old man with coronavirus disease 2019 (COVID-19) was admitted to the intensive care unit with respiratory failure, cytokine release syndrome (CRS), and skin ischemia – microthrombosis. Specific coagulation and inflammatory markers (D-dimer, ferritin, and C-reactive protein), along with the clinical picture, triggered the trial of recombinant tissue plasminogen activator (rt-PA) and tocilizumab. This was followed by resolution of the skin ischemia and CRS, while respiratory parameters improved. No major complications associated with rt-PA or tocilizumab occurred. The combination of rt-PA with targeted anti-inflammatory treatment could be a new therapeutic option for patients with COVID-19, ARDS, hyperinflammation, and increased blood viscosity.