RESUMO
The medical care of patients with hematological malignancies who develop coronavirus disease 2019 (COVID-19) has been a major challenge during the current pandemic. We herein describe a patient in the blast phase of chronic myeloid leukemia who was hospitalized for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patient was successfully treated with tocilizumab, and intubation was avoided. The severity of SARS-CoV-2 infection is mostly related to a severe acute respiratory distress syndrome that develops secondary to cytokine release syndrome, and interleukin 6 is the main cytokine involved in cytokine release syndrome. Very few reports have described the use of tocilizumab in patients with hematologic malignancies who develop SARS-CoV-2 infection, although a few cases of patients with multiple myeloma have been reported. To our knowledge, however, this is the first report of a SARS-CoV-2-infected patient in the blast phase of chronic myeloid leukemia who had a favorable response to treatment with tocilizumab. The management of patients with hematological malignancies who become infected with SARS-CoV-2 is a major challenge for practitioners, necessitating more specific research in this direction.
Assuntos
Tratamento Farmacológico da COVID-19 , COVID-19 , Anticorpos Monoclonais Humanizados , Crise Blástica/complicações , Crise Blástica/tratamento farmacológico , COVID-19/complicações , Humanos , SARS-CoV-2RESUMO
INTRODUCTION: Covid-19 infection usually manifests with respiratory symptoms, but neurological signs might be the mean symptom revealing this infection such as Guillain Barre syndrome (GBS).COVID-19 associated GBS seems to be more severe than non-COVID-19 GBS. CASE MANAGEMENT: We reported a 49 old-man admitted in the intensive care unit for bilateral ascending symmetrical paresthesia associated with lower limb numbness and sphincter disorders two weeks after an upper respiratory infection. The diagnosis of post-Covid-19 GBS was maintained, and the evolution was favorable after Intravenous Immunoglobulin (IVIg) and plasma exchange (PLEX) as a second therapy. CONCLUSION: This case report suggest the probable causal link between COVID 19 and GBS. This severe association prompts us to do further research that may help professionals in an early diagnosis and early treatment thus improving morbidity and mortality.