PMID- 36618789
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230111
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 10
IP  - 23
DP  - 2022 Dec
TI  - Effect of tocilizumab treatment in mildly-obese patients with coronavirus disease 
      2019: a case series.
PG  - 1263
LID - 10.21037/atm-2022-49 [doi]
LID - 1263
AB  - BACKGROUND: The coronavirus disease 2019 (COVID-19) caused by severe acute 
      respiratory syndrome coronavirus-2 (SARS-CoV-2) is an increasingly widespread 
      international medical problem. Several randomized trials and observational 
      studies in patients with COVID-19 have been performed. However, the standard 
      treatment strategy has not yet been established. The purpose of this study is to 
      report effect of tocilizumab treatment combined with remdesivir, dexamethasone, 
      and heparin on obese Japanese patients with COVID-19. Tocilizumab is a monoclonal 
      antibody against the interleukin-6 (IL-6) receptor. Obesity, characterized by 
      systemic enlarged adipocytes, promotes proinflammatory cytokine expression in 
      adipose tissue. More specifically, obesity induces detrimental adipocytokine 
      production including tumor necrosis factor-alpha (TNF-alpha), monocyte chemoattractant 
      protein-1 (MCP-1), and IL-6. In addition, its production in the adipose tissue is 
      associated with body mass index (BMI) and adipocyte size. IL-6 can promote 
      inflammation not only in the adipose tissues but also in endothelial cells and 
      triggers systemic inflammation. METHODS: A cross-sectional observational study 
      was conducted. The study sample consisted of 96 patients between August 2020 and 
      January 2021 at Showa University Fujigaoka Hospital. RESULTS: Overall, 56.3% (54 
      of 96) were administered with remdesivir, 54.2% (52 of 96) with dexamethasone, 
      19.8% (19 of 96) with anticoagulant therapy with heparin. Of the patients, nine 
      were administered tocilizumab with remdesivir, dexamethasone, and heparin. The 
      current study indicated that single-dose treatment of tocilizumab in combination 
      with remdesivir, dexamethasone, and heparin is beneficial for obese Japanese 
      patients with COVID-19. CONCLUSIONS: We believe that the severity of obesity is 
      related to the anti-IL-6 treatment sensitivity in patients with COVID-19.
CI  - 2022 Annals of Translational Medicine. All rights reserved.
FAU - Abe, Takashi
AU  - Abe T
AD  - Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 
      Fujigaoka, Yokohama, Japan.
FAU - Yamaguchi, Fumihiro
AU  - Yamaguchi F
AD  - Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 
      Fujigaoka, Yokohama, Japan.
FAU - Sakakura, Shunsuke
AU  - Sakakura S
AD  - Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 
      Fujigaoka, Yokohama, Japan.
FAU - Yamazaki, Yohei
AU  - Yamazaki Y
AD  - Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 
      Fujigaoka, Yokohama, Japan.
FAU - Shikama, Yusuke
AU  - Shikama Y
AD  - Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 
      Fujigaoka, Yokohama, Japan.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC9816833
OTO - NOTNLM
OT  - Coronavirus disease 2019 (COVID-19)
OT  - case series
OT  - interleukin-6 (IL-6)
OT  - obesity
OT  - tocilizumab
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://atm.amegroups.com/article/view/10.21037/atm-2022-49/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2023/01/10 06:00
MHDA- 2023/01/10 06:01
PMCR- 2022/12/01
CRDT- 2023/01/09 03:38
PHST- 2022/09/30 00:00 [received]
PHST- 2022/10/20 00:00 [accepted]
PHST- 2023/01/09 03:38 [entrez]
PHST- 2023/01/10 06:00 [pubmed]
PHST- 2023/01/10 06:01 [medline]
PHST- 2022/12/01 00:00 [pmc-release]
AID - atm-10-23-1263 [pii]
AID - 10.21037/atm-2022-49 [doi]
PST - ppublish
SO  - Ann Transl Med. 2022 Dec;10(23):1263. doi: 10.21037/atm-2022-49.