Preprint Case Report Version 1 This version is not peer-reviewed

Pulse Therapy with Corticosteroids and Intravenous Immunoglobulin in the Management of Severe Tocilizumab-Resistant COVID-19: A Report of Three Clinical Cases

Version 1 : Received: 18 June 2020 / Approved: 21 June 2020 / Online: 21 June 2020 (11:06:08 CEST)

How to cite: Sheianov, M.V.; Udalov, Y.D.; Ochkin, S.S.; Bashkov, A.N.; Shikunov, D.N.; Netrebina, A.P.; Kryntsilov, A.I.; Ozerov, A.E.; Samoilov, A.S. Pulse Therapy with Corticosteroids and Intravenous Immunoglobulin in the Management of Severe Tocilizumab-Resistant COVID-19: A Report of Three Clinical Cases. Preprints 2020, 2020060260 (doi: 10.20944/preprints202006.0260.v1). Sheianov, M.V.; Udalov, Y.D.; Ochkin, S.S.; Bashkov, A.N.; Shikunov, D.N.; Netrebina, A.P.; Kryntsilov, A.I.; Ozerov, A.E.; Samoilov, A.S. Pulse Therapy with Corticosteroids and Intravenous Immunoglobulin in the Management of Severe Tocilizumab-Resistant COVID-19: A Report of Three Clinical Cases. Preprints 2020, 2020060260 (doi: 10.20944/preprints202006.0260.v1).

Abstract

Three patients with severe life-threatening COVID-19 who failed to achieve substantial improvement on tocilizumab, received pulse therapy with corticosteroids (methylprednisolone, 1000 mg/day IV for three consecutive days) and intravenous immunoglobulin (20 g/day IV). This was associated with a prompt resolution of respiratory failure, elimination of cytokine release syndrome, and reversal of pulmonary CT changes. The treatment was generally safe and well tolerated. There was no evidence of protracted persistence of the virus in the patients who received pulse therapy. Randomized controlled trials are necessary to specify the efficacy and safety of high-dose methylprednisolone and intravenous immunoglobulin in the treatment of severe life-threatening COVID-19 separately or in combination.

Subject Areas

SARS-CoV-2; COVID-19; pulse therapy; corticosteroids; immunoglobulin

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