https://scholars.lib.ntu.edu.tw/handle/123456789/626918
標題: | Combined intravenous immunoglobulin and baricitinib treatment for severe COVID-19 with rhabdomyolysis: A case report | 作者: | Wu, Hao-Yu CHIEN-TING PAN CHIAO-FENG CHENG Lin, Chi-Ying SHENG-NAN CHANG Chen, Yi-Chung CHIH-YUAN WANG YEN-FU CHEN CHUNG-YU CHEN MATTHEW HUEI-MING MA JUEY-JEN HWANG |
關鍵字: | ARDS; Baricitinib; COVID-19; Creatine kinase; IVIg | 公開日期: | 九月-2021 | 出版社: | ELSEVIER TAIWAN | 卷: | 120 | 期: | 9 | 起(迄)頁: | 1777 | 來源出版物: | Journal of the Formosan Medical Association = Taiwan yi zhi | 摘要: | Since December 2019, the outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly around the world. The severity of COVID-19 ranges from asymptomatic carriers to severe acute respiratory distress syndrome (ARDS). Accumulating evidence has shown that COVID-19 may be associated with multiple organ complications including cardiac injury, viral myositis and neurological deficits. Numerous laboratory biomarkers including lymphocytes, platelets, lactate dehydrogenase and creatine kinase (CK) have been associated with the prognostic outcomes of patients with COVID-19. However, dynamic correlations between levels of biomarkers and clinical course have not been studied. Herein, we report a 74-year-old female patient with severe COVID-19 which progressed to ARDS requiring intubation and mechanical ventilation. The laboratory findings showed lymphopenia, hypogammaglobulinemia, and elevated inflammatory biomarkers and CK. She received intensive therapy with hydroxychloroquine, lopinavir/ritonavir, and azithromycin with limited effects. Immunomodulatory treatments with high dose intravenous immunoglobulin and baricitinib were prescribed with satisfactory biochemical, radiographic and clinical recovery. We found an interesting correlation between serum CK elevation and inflammatory biomarkers, which reflected clinical improvement. This case demonstrates that inflammatory biomarkers, cytokines, and CK level correlated with disease severity and treatment response, and combined use of intravenous immunoglobulin and baricitinib is a potential treatment in patients with severe COVID-19. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/626918 | ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2021.03.014 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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