Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy.
Identifieur interne : 000708 ( Main/Curation ); précédent : 000707; suivant : 000709Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy.
Auteurs : Vincenzo Montesarchio [Italie] ; Roberto Parrela [Italie] ; Chiara Iommelli [Italie] ; Antonella Bianco [Italie] ; Elio Manzillo [Italie] ; Fiorentino Fraganza [Italie] ; Cristiana Palumbo [Italie] ; Gaetano Rea [Italie] ; Patrizia Murino [Italie] ; Rosanna De Rosa [Italie] ; Luigi Atripaldi [Italie] ; Maurizio D'Abbraccio [Italie] ; Marcello Curvietto [Italie] ; Domenico Mallardo [Italie] ; Egidio Celentano [Italie] ; Antonio Maria Grimaldi [Italie] ; Marco Palla [Italie] ; Claudia Trojaniello [Italie] ; Maria Grazia Vitale [Italie] ; Samuel Lewis Million-Weaver [États-Unis] ; Paolo Antonio Ascierto [Oman]Source :
- Journal for immunotherapy of cancer [ 2051-1426 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Anticorps monoclonaux humanisés (usage thérapeutique), Antiviraux (usage thérapeutique), Biomarqueurs pharmacologiques (sang), Femelle (MeSH), Granulocytes neutrophiles (MeSH), Humains (MeSH), Infections à coronavirus (complications), Infections à coronavirus (imagerie diagnostique), Infections à coronavirus (traitement médicamenteux), Interleukine-6 (sang), Italie (MeSH), Mâle (MeSH), Numération des lymphocytes (MeSH), Pandémies (MeSH), Pneumopathie virale (complications), Pneumopathie virale (imagerie diagnostique), Pneumopathie virale (traitement médicamenteux), Récepteurs à l'interleukine-6 (antagonistes et inhibiteurs), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Études rétrospectives (MeSH).
- MESH :
- antagonistes et inhibiteurs : Récepteurs à l'interleukine-6.
- imagerie diagnostique : Infections à coronavirus, Pneumopathie virale.
- sang : Biomarqueurs pharmacologiques, Infections à coronavirus, Interleukine-6, Pneumopathie virale.
- traitement médicamenteux : Infections à coronavirus, Pneumopathie virale.
- usage thérapeutique : Anticorps monoclonaux humanisés, Antiviraux.
- Adulte d'âge moyen, Femelle, Granulocytes neutrophiles, Humains, Italie, Mâle, Numération des lymphocytes, Pandémies, Résultat thérapeutique, Sujet âgé, Études rétrospectives.
- Wicri :
- geographic : Italie.
English descriptors
- KwdEn :
- Aged (MeSH), Antibodies, Monoclonal, Humanized (therapeutic use), Antiviral Agents (therapeutic use), Biomarkers, Pharmacological (blood), Coronavirus Infections (complications), Coronavirus Infections (diagnostic imaging), Coronavirus Infections (drug therapy), Female (MeSH), Humans (MeSH), Interleukin-6 (blood), Italy (MeSH), Lymphocyte Count (MeSH), Male (MeSH), Middle Aged (MeSH), Neutrophils (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (diagnostic imaging), Pneumonia, Viral (drug therapy), Receptors, Interleukin-6 (antagonists & inhibitors), Retrospective Studies (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , antagonists & inhibitors : Receptors, Interleukin-6.
- chemical , blood : Biomarkers, Pharmacological, Interleukin-6.
- chemical , therapeutic use : Antibodies, Monoclonal, Humanized, Antiviral Agents.
- geographic : Italy.
- complications : Coronavirus Infections, Pneumonia, Viral.
- diagnostic imaging : Coronavirus Infections, Pneumonia, Viral.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- Aged, Female, Humans, Lymphocyte Count, Male, Middle Aged, Neutrophils, Pandemics, Retrospective Studies, Treatment Outcome.
Abstract
BACKGROUND
The inflammatory pathology observed in severe COVID-19 disease caused by the 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by elevated serum levels of C reactive protein (CRP) and cytokines, including interferon gamma, interleukin 8 (IL-8), and interleukin 6 (IL-6). Initial reports from the outbreak in Italy, China and the USA have provided anecdotal evidence of improved outcomes with the administration of anti-IL-6 agents, and large-scale trials evaluating these therapies are ongoing.
STUDY DESCRIPTION
In this retrospective case series, clinical outcomes and correlates of response to treatment with the IL-6 receptor antagonist sarilumab are described for 15 patients with COVID-19 from a single institution in Southern Italy. Among 10 patients whose symptoms improved after sarilumab treatment, rapid decreases in CRP levels corresponded with clinical improvement. Lower levels of IL-6 at baseline as well as lower neutrophil to lymphocyte ratio as compared with patients whose COVID-19 did not improve with treatment were associated with sarilumab-responsive disease.
CONCLUSIONS
This observation may reflect a possible clinical benefit regarding early intervention with IL-6-modulatory therapies for COVID-19 and that CRP could be a potential biomarker of response to treatment.
DOI: 10.1136/jitc-2020-001089
PubMed: 32784217
PubMed Central: PMC7418768
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wicri:level="1"><nlm:affiliation>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Palumbo, Cristiana" sort="Palumbo, Cristiana" uniqKey="Palumbo C" first="Cristiana" last="Palumbo">Cristiana Palumbo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Rea, Gaetano" sort="Rea, Gaetano" uniqKey="Rea G" first="Gaetano" last="Rea">Gaetano Rea</name><affiliation wicri:level="1"><nlm:affiliation>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Murino, Patrizia" sort="Murino, Patrizia" uniqKey="Murino P" first="Patrizia" last="Murino">Patrizia Murino</name><affiliation wicri:level="1"><nlm:affiliation>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="De Rosa, Rosanna" sort="De Rosa, Rosanna" uniqKey="De Rosa R" first="Rosanna" last="De Rosa">Rosanna De Rosa</name><affiliation wicri:level="1"><nlm:affiliation>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Atripaldi, Luigi" sort="Atripaldi, Luigi" uniqKey="Atripaldi L" first="Luigi" last="Atripaldi">Luigi Atripaldi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="D Abbraccio, Maurizio" sort="D Abbraccio, Maurizio" uniqKey="D Abbraccio M" first="Maurizio" last="D'Abbraccio">Maurizio D'Abbraccio</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Curvietto, Marcello" sort="Curvietto, Marcello" uniqKey="Curvietto M" first="Marcello" last="Curvietto">Marcello Curvietto</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Mallardo, Domenico" sort="Mallardo, Domenico" uniqKey="Mallardo D" first="Domenico" last="Mallardo">Domenico Mallardo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Celentano, Egidio" sort="Celentano, Egidio" uniqKey="Celentano E" first="Egidio" last="Celentano">Egidio Celentano</name><affiliation wicri:level="1"><nlm:affiliation>Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Grimaldi, Antonio Maria" sort="Grimaldi, Antonio Maria" uniqKey="Grimaldi A" first="Antonio Maria" last="Grimaldi">Antonio Maria Grimaldi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Palla, Marco" sort="Palla, Marco" uniqKey="Palla M" first="Marco" last="Palla">Marco Palla</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Trojaniello, Claudia" sort="Trojaniello, Claudia" uniqKey="Trojaniello C" first="Claudia" last="Trojaniello">Claudia Trojaniello</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Vitale, Maria Grazia" sort="Vitale, Maria Grazia" uniqKey="Vitale M" first="Maria Grazia" last="Vitale">Maria Grazia Vitale</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Million Weaver, Samuel Lewis" sort="Million Weaver, Samuel Lewis" uniqKey="Million Weaver S" first="Samuel Lewis" last="Million-Weaver">Samuel Lewis Million-Weaver</name><affiliation wicri:level="1"><nlm:affiliation>Independent Investigator, Madison, Wisconsin, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Independent Investigator, Madison, Wisconsin</wicri:regionArea></affiliation></author><author><name sortKey="Ascierto, Paolo Antonio" sort="Ascierto, Paolo Antonio" uniqKey="Ascierto P" first="Paolo Antonio" last="Ascierto">Paolo Antonio Ascierto</name><affiliation wicri:level="1"><nlm:affiliation>Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy paolo.ascierto@gmail.com.</nlm:affiliation><country wicri:rule="url">Oman</country><wicri:regionArea>Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32784217</idno><idno type="pmid">32784217</idno><idno type="doi">10.1136/jitc-2020-001089</idno><idno type="pmc">PMC7418768</idno><idno type="wicri:Area/Main/Corpus">000708</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000708</idno><idno type="wicri:Area/Main/Curation">000708</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000708</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy.</title><author><name sortKey="Montesarchio, Vincenzo" sort="Montesarchio, Vincenzo" uniqKey="Montesarchio V" first="Vincenzo" last="Montesarchio">Vincenzo Montesarchio</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Oncology, Azienda Ospedaliera dei Colli-Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medical Oncology, Azienda Ospedaliera dei Colli-Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Parrela, Roberto" sort="Parrela, Roberto" uniqKey="Parrela R" first="Roberto" last="Parrela">Roberto Parrela</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Iommelli, Chiara" sort="Iommelli, Chiara" uniqKey="Iommelli C" first="Chiara" last="Iommelli">Chiara Iommelli</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Oncology, Azienda Ospedaliera dei Colli-Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medical Oncology, Azienda Ospedaliera dei Colli-Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Bianco, Antonella" sort="Bianco, Antonella" uniqKey="Bianco A" first="Antonella" last="Bianco">Antonella Bianco</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Oncology, Azienda Ospedaliera dei Colli-Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medical Oncology, Azienda Ospedaliera dei Colli-Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Manzillo, Elio" sort="Manzillo, Elio" uniqKey="Manzillo E" first="Elio" last="Manzillo">Elio Manzillo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Fraganza, Fiorentino" sort="Fraganza, Fiorentino" uniqKey="Fraganza F" first="Fiorentino" last="Fraganza">Fiorentino Fraganza</name><affiliation wicri:level="1"><nlm:affiliation>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Palumbo, Cristiana" sort="Palumbo, Cristiana" uniqKey="Palumbo C" first="Cristiana" last="Palumbo">Cristiana Palumbo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Rea, Gaetano" sort="Rea, Gaetano" uniqKey="Rea G" first="Gaetano" last="Rea">Gaetano Rea</name><affiliation wicri:level="1"><nlm:affiliation>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Murino, Patrizia" sort="Murino, Patrizia" uniqKey="Murino P" first="Patrizia" last="Murino">Patrizia Murino</name><affiliation wicri:level="1"><nlm:affiliation>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="De Rosa, Rosanna" sort="De Rosa, Rosanna" uniqKey="De Rosa R" first="Rosanna" last="De Rosa">Rosanna De Rosa</name><affiliation wicri:level="1"><nlm:affiliation>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Atripaldi, Luigi" sort="Atripaldi, Luigi" uniqKey="Atripaldi L" first="Luigi" last="Atripaldi">Luigi Atripaldi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="D Abbraccio, Maurizio" sort="D Abbraccio, Maurizio" uniqKey="D Abbraccio M" first="Maurizio" last="D'Abbraccio">Maurizio D'Abbraccio</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli</wicri:regionArea></affiliation></author><author><name sortKey="Curvietto, Marcello" sort="Curvietto, Marcello" uniqKey="Curvietto M" first="Marcello" last="Curvietto">Marcello Curvietto</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Mallardo, Domenico" sort="Mallardo, Domenico" uniqKey="Mallardo D" first="Domenico" last="Mallardo">Domenico Mallardo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Celentano, Egidio" sort="Celentano, Egidio" uniqKey="Celentano E" first="Egidio" last="Celentano">Egidio Celentano</name><affiliation wicri:level="1"><nlm:affiliation>Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Grimaldi, Antonio Maria" sort="Grimaldi, Antonio Maria" uniqKey="Grimaldi A" first="Antonio Maria" last="Grimaldi">Antonio Maria Grimaldi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Palla, Marco" sort="Palla, Marco" uniqKey="Palla M" first="Marco" last="Palla">Marco Palla</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Trojaniello, Claudia" sort="Trojaniello, Claudia" uniqKey="Trojaniello C" first="Claudia" last="Trojaniello">Claudia Trojaniello</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Vitale, Maria Grazia" sort="Vitale, Maria Grazia" uniqKey="Vitale M" first="Maria Grazia" last="Vitale">Maria Grazia Vitale</name><affiliation wicri:level="1"><nlm:affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Million Weaver, Samuel Lewis" sort="Million Weaver, Samuel Lewis" uniqKey="Million Weaver S" first="Samuel Lewis" last="Million-Weaver">Samuel Lewis Million-Weaver</name><affiliation wicri:level="1"><nlm:affiliation>Independent Investigator, Madison, Wisconsin, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Independent Investigator, Madison, Wisconsin</wicri:regionArea></affiliation></author><author><name sortKey="Ascierto, Paolo Antonio" sort="Ascierto, Paolo Antonio" uniqKey="Ascierto P" first="Paolo Antonio" last="Ascierto">Paolo Antonio Ascierto</name><affiliation wicri:level="1"><nlm:affiliation>Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy paolo.ascierto@gmail.com.</nlm:affiliation><country wicri:rule="url">Oman</country><wicri:regionArea>Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal for immunotherapy of cancer</title><idno type="eISSN">2051-1426</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Antibodies, Monoclonal, Humanized (therapeutic use)</term><term>Antiviral Agents (therapeutic use)</term><term>Biomarkers, Pharmacological (blood)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (diagnostic imaging)</term><term>Coronavirus Infections (drug therapy)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Interleukin-6 (blood)</term><term>Italy (MeSH)</term><term>Lymphocyte Count (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Neutrophils (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (diagnostic imaging)</term><term>Pneumonia, Viral (drug therapy)</term><term>Receptors, Interleukin-6 (antagonists & inhibitors)</term><term>Retrospective Studies (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Anticorps monoclonaux humanisés (usage thérapeutique)</term><term>Antiviraux (usage thérapeutique)</term><term>Biomarqueurs pharmacologiques (sang)</term><term>Femelle (MeSH)</term><term>Granulocytes neutrophiles (MeSH)</term><term>Humains (MeSH)</term><term>Infections à coronavirus (complications)</term><term>Infections à coronavirus (imagerie diagnostique)</term><term>Infections à coronavirus (traitement médicamenteux)</term><term>Interleukine-6 (sang)</term><term>Italie (MeSH)</term><term>Mâle (MeSH)</term><term>Numération des lymphocytes (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (complications)</term><term>Pneumopathie virale (imagerie diagnostique)</term><term>Pneumopathie virale (traitement médicamenteux)</term><term>Récepteurs à l'interleukine-6 (antagonistes et inhibiteurs)</term><term>Résultat thérapeutique (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="antagonists & inhibitors" xml:lang="en"><term>Receptors, Interleukin-6</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Biomarkers, Pharmacological</term><term>Interleukin-6</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term><term>Antiviral Agents</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Italy</term></keywords><keywords scheme="MESH" qualifier="antagonistes et inhibiteurs" xml:lang="fr"><term>Récepteurs à l'interleukine-6</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Biomarqueurs pharmacologiques</term><term>Infections à coronavirus</term><term>Interleukine-6</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anticorps monoclonaux humanisés</term><term>Antiviraux</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Lymphocyte Count</term><term>Male</term><term>Middle Aged</term><term>Neutrophils</term><term>Pandemics</term><term>Retrospective Studies</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Granulocytes neutrophiles</term><term>Humains</term><term>Italie</term><term>Mâle</term><term>Numération des lymphocytes</term><term>Pandémies</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Italie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The inflammatory pathology observed in severe COVID-19 disease caused by the 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by elevated serum levels of C reactive protein (CRP) and cytokines, including interferon gamma, interleukin 8 (IL-8), and interleukin 6 (IL-6). Initial reports from the outbreak in Italy, China and the USA have provided anecdotal evidence of improved outcomes with the administration of anti-IL-6 agents, and large-scale trials evaluating these therapies are ongoing.</p></div><div type="abstract" xml:lang="en"><p><b>STUDY DESCRIPTION</b></p><p>In this retrospective case series, clinical outcomes and correlates of response to treatment with the IL-6 receptor antagonist sarilumab are described for 15 patients with COVID-19 from a single institution in Southern Italy. Among 10 patients whose symptoms improved after sarilumab treatment, rapid decreases in CRP levels corresponded with clinical improvement. Lower levels of IL-6 at baseline as well as lower neutrophil to lymphocyte ratio as compared with patients whose COVID-19 did not improve with treatment were associated with sarilumab-responsive disease.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>This observation may reflect a possible clinical benefit regarding early intervention with IL-6-modulatory therapies for COVID-19 and that CRP could be a potential biomarker of response to treatment.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32784217</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>02</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">2051-1426</ISSN><JournalIssue CitedMedium="Internet"><Volume>8</Volume><Issue>2</Issue><PubDate><Year>2020</Year><Month>08</Month></PubDate></JournalIssue><Title>Journal for immunotherapy of cancer</Title><ISOAbbreviation>J Immunother Cancer</ISOAbbreviation></Journal><ArticleTitle>Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">e001089</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1136/jitc-2020-001089</ELocationID><Abstract><AbstractText Label="BACKGROUND">The inflammatory pathology observed in severe COVID-19 disease caused by the 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by elevated serum levels of C reactive protein (CRP) and cytokines, including interferon gamma, interleukin 8 (IL-8), and interleukin 6 (IL-6). Initial reports from the outbreak in Italy, China and the USA have provided anecdotal evidence of improved outcomes with the administration of anti-IL-6 agents, and large-scale trials evaluating these therapies are ongoing.</AbstractText><AbstractText Label="STUDY DESCRIPTION">In this retrospective case series, clinical outcomes and correlates of response to treatment with the IL-6 receptor antagonist sarilumab are described for 15 patients with COVID-19 from a single institution in Southern Italy. Among 10 patients whose symptoms improved after sarilumab treatment, rapid decreases in CRP levels corresponded with clinical improvement. Lower levels of IL-6 at baseline as well as lower neutrophil to lymphocyte ratio as compared with patients whose COVID-19 did not improve with treatment were associated with sarilumab-responsive disease.</AbstractText><AbstractText Label="CONCLUSIONS">This observation may reflect a possible clinical benefit regarding early intervention with IL-6-modulatory therapies for COVID-19 and that CRP could be a potential biomarker of response to treatment.</AbstractText><CopyrightInformation>© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y" EqualContrib="Y"><LastName>Montesarchio</LastName><ForeName>Vincenzo</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Medical Oncology, Azienda Ospedaliera dei Colli-Monaldi Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Parrela</LastName><ForeName>Roberto</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Iommelli</LastName><ForeName>Chiara</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Medical Oncology, Azienda Ospedaliera dei Colli-Monaldi Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bianco</LastName><ForeName>Antonella</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Medical Oncology, Azienda Ospedaliera dei Colli-Monaldi Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Manzillo</LastName><ForeName>Elio</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fraganza</LastName><ForeName>Fiorentino</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Palumbo</LastName><ForeName>Cristiana</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rea</LastName><ForeName>Gaetano</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Murino</LastName><ForeName>Patrizia</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Rosa</LastName><ForeName>Rosanna</ForeName><Initials>R</Initials><Identifier Source="ORCID">0000-0001-8684-0008</Identifier><AffiliationInfo><Affiliation>Critical Area Department, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Atripaldi</LastName><ForeName>Luigi</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Health Services, Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>D'Abbraccio</LastName><ForeName>Maurizio</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases and Infectious Diseases Emergencies, Azienda Ospedaliera dei Colli-Cotugno Hospital, Napoli, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Curvietto</LastName><ForeName>Marcello</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mallardo</LastName><ForeName>Domenico</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Celentano</LastName><ForeName>Egidio</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Grimaldi</LastName><ForeName>Antonio Maria</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Palla</LastName><ForeName>Marco</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Trojaniello</LastName><ForeName>Claudia</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vitale</LastName><ForeName>Maria Grazia</ForeName><Initials>MG</Initials><AffiliationInfo><Affiliation>Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Million-Weaver</LastName><ForeName>Samuel Lewis</ForeName><Initials>SL</Initials><Identifier Source="ORCID">0000-0001-9057-6326</Identifier><AffiliationInfo><Affiliation>Independent Investigator, Madison, Wisconsin, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ascierto</LastName><ForeName>Paolo Antonio</ForeName><Initials>PA</Initials><Identifier Source="ORCID">0000-0002-8322-475X</Identifier><AffiliationInfo><Affiliation>Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy paolo.ascierto@gmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Immunother Cancer</MedlineTA><NlmUniqueID>101620585</NlmUniqueID><ISSNLinking>2051-1426</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D061067">Antibodies, Monoclonal, Humanized</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D054316">Biomarkers, Pharmacological</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C508600">IL6 protein, human</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C508603">IL6R protein, human</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D015850">Interleukin-6</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019947">Receptors, Interleukin-6</NameOfSubstance></Chemical><Chemical><RegistryNumber>NU90V55F8I</RegistryNumber><NameOfSubstance UI="C000592401">sarilumab</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="ErratumIn"><RefSource>J Immunother Cancer. 2020 Sep;8(2):</RefSource><PMID Version="1">32895295</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D061067" MajorTopicYN="N">Antibodies, Monoclonal, Humanized</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D054316" MajorTopicYN="N">Biomarkers, Pharmacological</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015850" MajorTopicYN="N">Interleukin-6</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007558" MajorTopicYN="N" Type="Geographic">Italy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018655" MajorTopicYN="N">Lymphocyte Count</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009504" MajorTopicYN="N">Neutrophils</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019947" MajorTopicYN="N">Receptors, Interleukin-6</DescriptorName><QualifierName UI="Q000037" MajorTopicYN="N">antagonists & inhibitors</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">case reports</Keyword><Keyword MajorTopicYN="Y">immunomodulation</Keyword><Keyword MajorTopicYN="Y">inflammation mediators</Keyword></KeywordList><CoiStatement>Competing interests: AMG: advisory and consultant role for BMS, MSD and Novartis; and travel grants from BMS, Merck Serono, Pierre Fabre, Roche and Novartis. PAA: consultant/advisory role for Bristol-Myers Squibb, Roche-Genentech, Merck Sharp & Dohme, Array, Novartis, Merck Serono, Pierre Fabre, Incyte, NewLink Genetics, Genmab, MedImmune, AstraZeneca, Syndax, SunPharma, Sanofi, Idera, Ultimovacs, Sandoz, Immunocore, 4SC, Alkermes, Italfarmaco, and Nektar; research funds from Bristol-Myers Squibb, Roche-Genentech, and Array; and travel support from MSD.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>07</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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