Working Paper Case Report Version 1 This version is not peer-reviewed

CIGB-258, An Immunomodulatory Peptide for the Treatment of a COVID-19-associated Hepatic Encephalopathy: A Case Report

Version 1 : Received: 9 September 2020 / Approved: 11 September 2020 / Online: 11 September 2020 (05:49:43 CEST)

How to cite: Dominguez-Horta, M.D.C. CIGB-258, An Immunomodulatory Peptide for the Treatment of a COVID-19-associated Hepatic Encephalopathy: A Case Report. Preprints 2020, 2020090240 Dominguez-Horta, M.D.C. CIGB-258, An Immunomodulatory Peptide for the Treatment of a COVID-19-associated Hepatic Encephalopathy: A Case Report. Preprints 2020, 2020090240

Abstract

Hepatic encephalopathy is a complex life-threatening neuropsychiatric syndrome, which can be associated with acute inflammation. It can be found in cases of acute liver failure caused by a viral infection. Reports of patients infected with SARS-CoV-2 have described hepatic encephalopathy. Therapy with immunomodulators can be an effective choice for this clinical condition. CIGB-258 is an immunomodulatory peptide with anti-inflammatory properties derived from cellular stress protein 60 (HSP60). We report a case of a 55-years-old woman diagnosed with COVID-19 and hepatic encephalopathy characterized by episodes of anxiety, delirium, confusion and seizure, according to her clinical history, laboratory and radiological data. Levels of aspartate aminotransferase, alanine aminotransferase , plasma ammonia and alkaline phosphatase were increased and inflammatory biomarkers such as interleukin 6 and 10 were over the normal range. The patient received an intravenous administration of 1 mg of CIGB-258, every 12 hours during four days, followed by 1 mg daily for another three days without adverse reactions. Neurological symptoms disappeared completely at by the fourth days after starting therapy, and inflammatory biomarkers noticeably decreased, but not all of them reach the normal values. This case highlights the outcomes of a severe COVID-19 patient with hepatic encephalopathy, treated with CIGB-258. The patient recovered successfully and the liver enzymes, plasma ammonia and biomarkers associated with hyperinflammation were reduced. These results support clinical investigations of CIGB-258 as a therapeutic agent in COVID-19.TRIAL REGISTRATION: RPCEC00000313

Subject Areas

COVID-19; SARS-CoV-2; hepatic encephalopathy; CIGB-258

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