{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T07:48:09Z","timestamp":1661500089274},"reference-count":0,"publisher":"Journal of Nepal Medical Association (JNMA)","issue":"252","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Nepal Med Assoc"],"abstract":"<jats:p>The in-hospital mortality in patients with COVID-19 could be correlated with severe acute respiratory syndrome coronavirus-2 induced hyper-inflammation, which is attributed to an unconstrained inflammatory cytokine storm. The pro-inflammatory cytokine, specifically, interleukin-6 plays a prominent role in the cytokine storm and may result in alveolar-capillary blood-gas exchange dysfunction. Therefore, the method to block the signal transduction pathway of interleukin-6 could be a potential treatment for severe COVID-19 patients. In this case series of three patients with severe COVID-19, we focus on the rationale for utilization of tocilizumab, an anti-interleukin-6 receptor antibody, which could block the signal transduction pathway of interleukin-6. The observations from this study allowed us to hypothesize that the infusions of tocilizumab may not reduce the elevated level of interleukin-6, and hence may not be a significant therapeutic for reducing in-hospital mortality associated with COVID-19. Additionally, it could also be speculated that interleukin-6 may not be a potentially actionable target cytokine to treat COVID-19-associated cytokine storms. <\/jats:p>","DOI":"10.31729\/jnma.7364","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T18:29:00Z","timestamp":1659378540000},"page":"727-731","source":"Crossref","is-referenced-by-count":1,"title":["Role of Tocilizumab in the Treatment of COVID-19 Patients with Cytokine Storm: A Case Series"],"prefix":"10.31729","volume":"60","author":[{"given":"Ajaya","family":"Basnet","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahendra Raj","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossu","family":"Thapa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basanta","family":"Tamang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Apurba","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabhat","family":"Rawal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sailendra Kumar","family":"Duwal Shrestha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lochan","family":"Karki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiba Kumar","family":"Rai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16919","published-online":{"date-parts":[[2022,8,1]]},"container-title":["Journal of Nepal Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/www.jnma.com.np\/jnma\/index.php\/jnma\/article\/download\/7364\/4298","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.jnma.com.np\/jnma\/index.php\/jnma\/article\/download\/7364\/4298","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T18:29:00Z","timestamp":1659378540000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jnma.com.np\/jnma\/index.php\/jnma\/article\/view\/7364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,1]]},"references-count":0,"journal-issue":{"issue":"252","published-online":{"date-parts":[[2022,8,1]]}},"URL":"https:\/\/doi.org\/10.31729\/jnma.7364","relation":{},"ISSN":["1815-672X","0028-2715"],"issn-type":[{"value":"1815-672X","type":"electronic"},{"value":"0028-2715","type":"print"}],"subject":[],"published":{"date-parts":[[2022,8,1]]}}}