RESUMEN
OBJECTIVE: SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2)-related pneumonia, referred to as COVID-19 (Coronavirus Disease 19), is a public health emergency as it carries high morbidity, mortality, and has no approved specific pharmacological treatments. In this case series, we aimed to report preliminary data obtained with anti-complement C5 therapy with eculizumab in COVID-19 patients admitted to intensive care unit (ICU) of ASL Napoli 2 Nord. PATIENTS AND METHODS: This is a case series of patients with a confirmed diagnosis of SARS-CoV2 infection and severe pneumonia or ARDS who were treated with up to 4 infusions of eculizumab as an off-label agent. Patients were also treated with anticoagulant therapy with Enoxaparin 4000 IU/day via subcutaneous injection, antiviral therapy with Lopinavir 800 mg/day + Ritonavir 200 mg/day, hydroxychloroquine 400 mg/day, ceftriaxone 2 g/day IV, vitamine C 6 g/day for 4 days, and were on Non-Invasive Ventilation (NIV). RESULTS: We treated four COVID-19 patients admitted to the intensive care unit because of severe pneumonia or ARDS. All patients successfully recovered after treatment with eculizumab. Eculizumab induced a drop in inflammatory markers. Mean C Reactive Protein levels dropped from 14.6 mg/dl to 3.5 mg/dl and the mean duration of the disease was 12.8 days. CONCLUSIONS: Eculizumab has the potential to be a key player in treatment of severe cases of COVID-19. Our results support eculizumab use as an off-label treatment of COVID-19, pending confirmation from the ongoing SOLID-C19 trial.
Asunto(s)
Coronavirus , Síndrome Respiratorio Agudo Grave , Anticuerpos Monoclonales Humanizados , Betacoronavirus , COVID-19 , Activación de Complemento , Infecciones por Coronavirus , Humanos , Pandemias , Neumonía Viral , SARS-CoV-2RESUMEN
Fetal alcohol Syndrome (FAS) is a well recognized pattern of malformations, produced by a heavy and chronic intake of ethanol during pregnancy. The Authors report a clinical case of FAS, observed during an epidemiological study on alcohol abuse of pregnancy women. They describe the anomalies and malformations of a newborn by a heavy drinking mother, and of his seven year old brother. Finally, the Authors consider the toxicological and preventive aspects of problem: counselling women of child-bearing age to the dangers of alcoholic intake during the gestation period is a professional responsibility.