Eculizumab treatment in patients with COVID-19: preliminary results from real-life ASL Napoli 2 Nord experience
Authors: F. Diurno, F.G. Numis, G. Porta, F. Cirillo, S. Maddaluno, A. Ragozzino, P. De Negri, C. Di Gennaro, A. Pagano, E. Allegorico, L. Bressy, G. Bosso, A. Ferrara, C. Serra, A. Montisci, M. D’Amico, S. Schiano Lo Morello, G. Di Costanzo, A.G. Tucci, P. Marchetti, U. Di Vincenzo, I. Sorrentino, A. Casciotta, M. Fusco, C. Buonerba, M. Berretta, M. Ceccarelli, G. Nunnari, Y. Diessa, S. Cicala, G. Facchini
Affiliation: Department of Emergency and Critical Care, ASL Napoli 2 Nord, “S.M. delle Grazie” Hospital, Pozzuoli (NA), Italy.
gaetano.facchini@aslnapoli2nord.it
Objective
Objective:
SARS-CoV-2–related pneumonia (COVID-19) is a global health emergency due to its high morbidity and mortality and the lack of approved specific pharmacological treatments. This case series presents real-life preliminary data on anti-complement C5 therapy with eculizumab in COVID-19 patients admitted to the intensive care unit at ASL Napoli 2 Nord.
Patients and Methods
Patients and Methods:
The case series includes patients with confirmed SARS-CoV-2 infection and severe pneumonia or ARDS treated with up to four off-label infusions of eculizumab. All patients also received: enoxaparin 4,000 IU/day, lopinavir 800 mg/day + ritonavir 200 mg/day, hydroxychloroquine 400 mg/day, ceftriaxone 2 g/day IV, vitamin C 6 g/day for 4 days and non-invasive ventilation (NIV).
Results
Results:
Four ICU COVID-19 patients with severe pneumonia or ARDS were treated with eculizumab. All achieved clinical recovery. Eculizumab induced a significant reduction in inflammatory markers: mean C-reactive protein decreased from 14.6 mg/dl to 3.5 mg/dl. The mean disease duration was 12.8 days.
Conclusions
Conclusions:
Eculizumab appears to have important therapeutic potential in severe COVID-19 cases. Our preliminary results support its off-label use pending confirmation from the ongoing SOLID-C19 trial.