Eculizumab treatment in patients with COVID-19
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) represents a public health emergency due to its high morbidity and mortality and the absence of specific approved treatments. This case series reports preliminary data on anti-complement C5 therapy (eculizumab) in COVID-19 ICU patients admitted to ASL Napoli 2 Nord.
Patients and Methods
Patients and Methods: This case series includes patients with confirmed SARS-CoV-2 infection and severe pneumonia or acute respiratory distress syndrome (ARDS) treated with up to four off-label infusions of eculizumab. All patients also received standard COVID-19 treatments: Enoxaparin 4,000 IU/day SC, 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 severe COVID-19 ICU patients were treated with eculizumab. All recovered successfully. Eculizumab produced a marked reduction in inflammatory markers: mean C-reactive protein (CRP) decreased from 14.6 mg/dl to 3.5 mg/dl, and mean disease duration was 12.8 days.
Conclusions
Conclusions: Eculizumab shows potential as a therapeutic option in severe COVID-19 cases. These preliminary results support its off-label use pending evidence from the ongoing SOLID-C19 clinical trial.