{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:28:36Z","timestamp":1792452516232,"version":"4.5.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"FI1","license":[{"start":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>SARS-CoV-2 is known to induce a cytokine storm, a hyperinflammatory state driven by up-regulation of interleukin 6 (IL-6) and immunomodulatory chemokines that may result in acute heart failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 65-year-old woman with confirmed SARS-CoV-2 developed shock with multiorgan system failure, including acute biventricular heart failure, 2 weeks after the initial onset of fever, cough, and shortness of breath. The patient experienced myocardial recovery within 48 h after administration of tocilizumab, a humanized monoclonal anti-IL-6 receptor antibody, and multiple supportive vasoactive medications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The differential diagnosis of acute heart failure in critically ill patients with COVID-19 infection is broad, including sepsis-induced cardiomyopathy, Takotsubo syndrome, viral lymphocytic myocarditis, and acute coronary syndrome. Immunomodulatory treatment with tocilizumab may benefit patients who develop cardiogenic shock associated with SARS-CoV-2-induced cytokine storm.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa188","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T19:54:03Z","timestamp":1595015643000},"page":"1-6","source":"Crossref","is-referenced-by-count":23,"title":["Successful treatment of acute heart failure in COVID-19-induced cytokine storm with tocilizumab: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0602-2684","authenticated-orcid":false,"given":"Kalyan R","family":"Chitturi","sequence":"first","affiliation":[{"name":"Department of Medicine, Houston Methodist Hospital, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Thacker","sequence":"additional","affiliation":[{"name":"Department of Medicine, Houston Methodist Hospital, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukhtar A","family":"Al-Saadi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Houston Methodist Hospital, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahwash","family":"Kassi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,17]]},"reference":[{"key":"2021012109530228400_ytaa188-B1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.healun.2020.03.012","article-title":"COVID-19 illness in native and immunosuppressed states: a clinical\u2013therapeutic staging proposal","volume":"39","author":"Siddiqi","year":"2020","journal-title":"J Heart Lung Transplant"},{"key":"2021012109530228400_ytaa188-B2","doi-asserted-by":"crossref","first-page":"105954","DOI":"10.1016\/j.ijantimicag.2020.105954","article-title":"The cytokine release syndrome (CRS) of severe COVID-19 and interleukin-6 receptor (IL-6R) antagonist tocilizumab may be the key to reduce the mortality","volume":"55","author":"Zhang","year":"2020","journal-title":"Int J Antimicrob Agents"},{"key":"2021012109530228400_ytaa188-B3","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1093\/eurheartj\/ehq014","article-title":"Inflammatory cytokines in heart failure: roles in aetiology and utility as biomarkers","volume":"31","author":"Tamariz","year":"2010","journal-title":"Eur Heart J"},{"key":"2021012109530228400_ytaa188-B4","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). 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