Clinical Management of Il-6 Driven Cytokine Storm Related to COVID-19 in a Patient with Recent Spinal Cord Stimulator Implants: A Case Report

Alfonso Papa; Maria Teresa Di Dato; Pietro Buonavolonta; Elisabetta Saracco; Anna Maria Salzano; Beniamino Casale

doi:10.5812/aapm.104151

Clinical Management of Il-6 Driven Cytokine Storm Related to COVID-19 in a Patient with Recent Spinal Cord Stimulator Implants: A Case Report

Anesth Pain Med. 2020 Aug 1;10(4):e104151. doi: 10.5812/aapm.104151. eCollection 2020 Aug.

Authors

Alfonso Papa¹, Maria Teresa Di Dato¹, Pietro Buonavolonta¹, Elisabetta Saracco¹, Anna Maria Salzano¹, Beniamino Casale²

Affiliations

¹ Pain Department, Monaldi Hospital Napoli, Naples, Italy.
² IPAS Moleculat Immunological Therapy AO Ospedali dei Colli- Monaldi Hospital Napoli, Naples, Italy.

Abstract

Introduction: In the last months of 2019, the advent of a new virus called SARS-CoV-2 caused the spread of a pandemic disease, COVID-19, that has afflicted patients with chronic pain.

Case presentation: We describe a COVID-19 patient recently implanted with a spinal cord stimulator for FBSS, treated with Tocilizumab for cytokine storm complicating SARS-COV-2 infection. This patient developed a delayed hyperimmune reaction, causing an inflammatory reaction in the surgical pocket site, well treated with total remission. The total resolution of this local reaction occurred after the resolution of systemic COVID-19 infection by Tocilizumab.

Conclusions: We discuss the balance between damage-associated molecular patterns (DAMPs) and pathogen-recognition receptors (PRRs), and the putative role of polymorphism in the IL-6/174 position of the promoter region.

Keywords: COVID-19; Cytokine Storm; IL-6; Spinal Cord Stimulation; Tocilizumab.

Publication types

Case Reports