• Int. J. Infect. Dis. · Aug 2020

    Case Reports

    Combination of thrombolytic and immunosuppressive therapy for coronavirus disease 2019: A case report.

    • Panagiotis Papamichalis, Antonios Papadogoulas, Periklis Katsiafylloudis, Apostolia-Lemonia Skoura, Michail Papamichalis, Evangelia Neou, Dimitrios Papadopoulos, Spyridon Karagiannis, Tilemachos Zafeiridis, Dimitris Babalis, and Apostolos Komnos.
    • Intensive Care Unit, General Hospital of Larissa, Larissa, Greece. Electronic address: ppapamih@med.uth.gr.
    • Int. J. Infect. Dis. 2020 Aug 1; 97: 90-93.

    AbstractIn a proportion of patients, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a multisystem syndrome characterized by hyperinflammation, acute respiratory distress syndrome (ARDS), and hypercoagulability. A 68-year-old man with coronavirus disease 2019 (COVID-19) was admitted to the intensive care unit with respiratory failure, cytokine release syndrome (CRS), and skin ischemia - microthrombosis. Specific coagulation and inflammatory markers (D-dimer, ferritin, and C-reactive protein), along with the clinical picture, triggered the trial of recombinant tissue plasminogen activator (rt-PA) and tocilizumab. This was followed by resolution of the skin ischemia and CRS, while respiratory parameters improved. No major complications associated with rt-PA or tocilizumab occurred. The combination of rt-PA with targeted anti-inflammatory treatment could be a new therapeutic option for patients with COVID-19, ARDS, hyperinflammation, and increased blood viscosity.Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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