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Case Reports
. 2021 Jan;159(1):e7-e11.
doi: 10.1016/j.chest.2020.09.077. Epub 2020 Sep 12.

Etoposide as Salvage Therapy for Cytokine Storm Due to Coronavirus Disease 2019

Maulin Patel  1 , Eduardo Dominguez  2 , Daniel Sacher  2 , Parag Desai  2 , Ashwin Chandar  3 , Michael Bromberg  3 , Roberto Caricchio  4 , Gerard J Criner  2 ; Temple University COVID-19 Research Group
Affiliations
Case Reports

Etoposide as Salvage Therapy for Cytokine Storm Due to Coronavirus Disease 2019

Maulin Patel et al. Chest. 2021 Jan.

Abstract

Coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality because of a lack of effective therapies. Therapeutic strategies under investigation target the overactive cytokine response with anti-cytokine or immunomodulators therapies. We present a unique case of severe cytokine storm resistant to multiple anti-cytokine therapies, but eventually responsive to etoposide. Thus, etoposide may have a role as salvage therapy in treatment of cytokine storm in COVID-19. To our knowledge, this is the first reported case of use of etoposide in COVID-19.

Keywords: COVID-19; etoposide.

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Figures

Figure 1
Figure 1
CT angiography of the thorax. A, Arrow shows right lower lobe pulmonary embolism. B, Multifocal peripheral ground-glass opacities.
Figure 2
Figure 2
Trends of laboratory and clinical markers.
Figure 3
Figure 3
Chest radiograph progression for patient 1. A, Day 1, showing diffuse bilateral interstitial and airspace opacities throughout both lungs with a basilar predominance. B, Day 8, with improved interstitial/airspace opacities. C, Day 14, increased infiltrate on right lung base. D, Day 20, worsening patchy opacities with basilar predominance. E, Day 26, improvement in opacities 5 days after receiving etoposide. F, Day 29, continued improvement in opacities after etoposide.
See this image and copyright information in PMC

Comment in

  • Etoposide for Cytokine Storm Because of Coronavirus Disease 2019.
    Delgado-López PD, Buzón-Martín L, Montero-Baladia M, Astigarraga I. Delgado-López PD, et al. Chest. 2021 Apr;159(4):1678-1679. doi: 10.1016/j.chest.2020.10.090. Epub 2021 Apr 6. Chest. 2021. PMID: 34021998 Free PMC article. No abstract available.
  • Response.
    Patel M, Dominguez E, Sacher D, Desai P, Chandar A, Bromberg M, Caricchio R, Criner GJ. Patel M, et al. Chest. 2021 Apr;159(4):1679. doi: 10.1016/j.chest.2020.11.035. Epub 2021 Apr 6. Chest. 2021. PMID: 34021999 Free PMC article. No abstract available.

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