LitCovid-sentences  

PMC:7195088 / 61276-65750 JSONTXT 11 Projects

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Id Subject Object Predicate Lexical cue
T445 0-93 Sentence denotes Question 6. should other immunosuppressive and/or immunomodulatory therapies be administered?
T446 94-379 Sentence denotes According to some recent evidence, some patients with COVID-19 may develop secondary haemophagocytic lymphohistiocytosis, an underrecognized hyperinflammatory syndrome characterized by a fulminant and fatal hypercytokinaemia, with development of ARDS and multiorgan failure [46,47,67].
T447 380-515 Sentence denotes Consequently, immunosuppressive and/or immunomodulatory therapies have been proposed to contrast COVID-19–associated hyperinflammation.
T448 516-888 Sentence denotes Tocilizumab is a recombinant humanized monoclonal antibody inhibiting membrane-bound and soluble IL-6 receptors [68] and is currently approved for the treatment of patients with rheumatoid arthritis, giant-cell arteritis, juvenile idiopathic arthritis and patients with chimeric antigen receptor T-cell–induced severe or life-threatening cytokine release syndrome [68,69].
T449 889-1044 Sentence denotes In this regard, tocilizumab may help mitigate the cytokine release syndrome by decreasing cytokine concentrations and acute-phase reactant production [70].
T450 1045-1164 Sentence denotes In a recent preprint paper, Xu et al. [71] reported their experience of treating 21 COVID-19 patients with tocilizumab.
T451 1165-1555 Sentence denotes In their still-to-be-peer-reviewed case series, the following were observed after tocilizumab administration: (a) reduction in body temperature (21/21, 100%); (b) improved blood oxygenation (15/21, 71.4%); (c) normalization of lymphocyte count (10/17, 58.8%); (d) normalization of C-reactive protein (16/19, 82.4%); and (c) resolution of abnormalities on computed tomography (19/21, 90.5%).
T452 1556-1682 Sentence denotes Interestingly, no adverse reactions were observed after tocilizumab administration, but long-term follow-up was not available.
T453 1683-1841 Sentence denotes Tocilizumab has been deemed by Chinese National Health Commission to be a possible treatment option for patients with severe COVID-19 with elevated IL-6 [72].
T454 1842-2024 Sentence denotes The recommended dose is 4 to 8 mg/kg or 400 mg standard dose provided intravenously once, with the option to repeat a dose after 8 to 12 hours (not to exceed a total dose of 800 mg).
T455 2025-2222 Sentence denotes However, it should be noted that the optimal time for administering tocilizumab has not yet been fully elucidated; nor is there a clear IL-6 threshold associated with progression to severe disease.
T456 2223-2365 Sentence denotes At the time of writing, there are at least eight ongoing RCT evaluating the efficacy and safety of tocilizumab in COVID-19 patients (Table 2).
T457 2366-2562 Sentence denotes Other immune-modulatory drugs including anakinra (interleukin 1 receptor antagonist) or Janus kinase family enzyme inhibitors have been proposed for the management of SARS-CoV-2–infected patients.
T458 2563-2662 Sentence denotes Notably, there is currently no supporting clinical evidence, and RCT are ongoing (Table 2) [67,73].
T459 2663-2934 Sentence denotes Finally, modifications of the immune response through administration of high-dose intravenous immunoglobulin or convalescent plasma have also been proposed or used in small case series, and they merit further investigation in dedicated RCT [[74], [75], [76], [77], [78]].
T460 2936-2956 Sentence denotes Question 6 statement
T461 2957-3111 Sentence denotes Owing to the lack of high-level evidence, administration of tocilizumab in patients with COVID-19 should preferentially occur within the framework of RCT.
T462 3112-3438 Sentence denotes Off-label use according to local protocols and consent procedures may be considered only in those COVID-19 patients excluded from RCT (or hospitalized where RCT are not available or still to be implemented) and who are worsening while receiving standard supportive care (in the absence of concomitant/superimposed infections).
T463 3439-3915 Sentence denotes In our opinion, this could be a reasonable off-label use of tocilizumab in these early phases of the COVID-19 pandemic, although patients and physicians should be fully aware that currently there is only a non–peer-reviewed, noncomparative, observational experience (very low evidence from an unreviewed cases series), and that it only supports a potential favourable effect on inflammatory signs and symptoms, while there is no information on any possible effect on survival.
T464 3916-4135 Sentence denotes In the absence of clinical studies, we suggest that also other immunosuppressive and/or immunomodulatory therapies (e.g. anakinra, Janus kinase family enzyme inhibitors) should be preferentially administered within RCT.
T465 4136-4474 Sentence denotes This also applies to modifications of the immune response through high-dose intravenous immunoglobulins or plasma from convalescent patients, which, although promising in very small case series, both deserve dedicated RCT investigation to clearly understand their tolerability as well as the role they play in affecting COVID-19 outcomes.