key: cord-0821408-zv5kb2p2
authors: Gautier-Vargas, Gabriela; Baldacini, Clement; Benotmane, Ilies; Keller, Nicolas; Perrin, Peggy; Moulin, Bruno; Caillard, Sophie
title: Rapid resolution of cytokine release syndrome and favorable clinical course of severe COVID-19 in a kidney transplant recipient treated with tocilizumab
date: 2020-06-04
journal: Kidney Int
DOI: 10.1016/j.kint.2020.05.022
sha: 7cecc4ccf1a760412c07aea001cc857b3fd75eca
doc_id: 821408
cord_uid: zv5kb2p2

nan

dyspnea and hypoxia (blood oxygen saturation of 94% with an oxygen flow rate of 2 L/min). The RT-PCR test for SARS-CoV-2 detection was positive. There was also evidence of acute kidney injury (AKI) Kidney Disease: Improving Global Outcomes stage 1. Immunosuppression reduction consisted of mycophenolic acid withdrawal and reduced-dose cyclosporine. The patient was hydrated and antibiotic prophylaxis was started (Table 1) . Unfortunately, the patient's respiratory function further deteriorated and laboratory findings were suggestive of a CRS with a remarkably elevated (431 pg/mL) serum IL-6 levels. A single intravenous infusion of tocilizumab (8 mg/kg/day) was attempted. Two days after, oxygen was not longer required ( Figure 1 ). The patient was discharged home and completed recovered from AKI.

Early detection of CRS biomarkers is recommended and should prompt antiinflammatory interventions. Larger studies are needed to confirm the utility and safety of IL-6 inhibition combined with dexamethasone in KT recipients with COVID-19. 

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