Successful treatment of acute heart failure in COVID-19-induced cytokine storm with tocilizumab: A case report

Kalyan R. Chitturi, Sameer Thacker, Mukhtar A. Al-Saadi, Mahwash Kassi, Gianluigi Savarese, Giulia Ferrannini, Davide Stolfo, Christian Fielder Camm, Ross Thomson

Research output: Contribution to journalArticle

Abstract

SARS-CoV-2 is known to induce a cytokine storm, a hyperinflammatory state driven by up-regulation of interleukin 6 (IL-6) and immunomodulatory chemokines that may result in acute heart failure. Case summary: A 65-year-old woman with confirmed SARS-CoV-2 developed shock with multiorgan system failure, including acute biventricular heart failure, 2 weeks after the initial onset of fever, cough, and shortness of breath. The patient experienced myocardial recovery within 48 h after administration of tocilizumab, a humanized monoclonal anti-IL-6 receptor antibody, and multiple supportive vasoactive medications. Discussion: The differential diagnosis of acute heart failure in critically ill patients with COVID-19 infection is broad, including sepsis-induced cardiomyopathy, Takotsubo syndrome, viral lymphocytic myocarditis, and acute coronary syndrome. Immunomodulatory treatment with tocilizumab may benefit patients who develop cardiogenic shock associated with SARS-CoV-2-induced cytokine storm.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalEuropean Heart Journal - Case Reports
Volume4
Issue numberFI1
DOIs
StatePublished - Oct 1 2020

Keywords

  • COVID-19
  • Case report
  • Cytokine
  • Heart failure
  • Myocarditis
  • Takotsubo
  • Tocilizumab

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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