Rapid Radiological Worsening and Cytokine Storm Syndrome in COVID-19 Pneumonia

Yvon Ruch; Charlotte Kaeuffer; Aurélien Guffroy; Nicolas Lefebvre; Yves Hansmann; François Danion

doi:10.12890/2020_001822

Rapid Radiological Worsening and Cytokine Storm Syndrome in COVID-19 Pneumonia

Eur J Case Rep Intern Med. 2020 Jul 2;7(7):001822. doi: 10.12890/2020_001822. eCollection 2020.

Authors

Yvon Ruch¹, Charlotte Kaeuffer¹, Aurélien Guffroy², Nicolas Lefebvre¹, Yves Hansmann¹, François Danion¹

Affiliations

¹ Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France.
² Department of Clinical Immunology and Internal Medicine, Strasbourg University Hospital, Strasbourg, France.

Abstract

Background: In June 2020, a large randomised controlled clinical trial in the UK found that dexamethasone was effective in reducing the number of deaths in patients with severe coronavirus disease 2019 (COVID-19).

Case description: We describe a patient with rapid worsening of COVID-19 pneumonia and its dramatic improvement under corticosteroids.

Discussion: Corticosteroids could be useful in patients with an inflammatory profile, considering that acute respiratory distress syndrome may be the consequence of cytokine storm syndrome.

Learning points: One of the main pathophysiological hypotheses for severe COVID-19 pneumonia is inappropriate immunological hyperactivation.Corticosteroid therapy may be useful in these patients.

Keywords: COVID-19; computed tomography; coronavirus; corticosteroids; cytokine storm syndrome.