LAUSR

Corona virus represents nowadays the hot topic in the scientific world due to the outbreak of a novel serotype formerly named coronavirus disease (COVID)-19 and now identified as severe acute respiratory syndrome (SARS)-COV-2 [1]. The disease has been firstly reported in Wuhan, Yubei District of the Republic of China, when in December 2019 its outbreak affected around 80,000 people and provoked about 3000 deaths due to pulmonary complications [1]. The virus rapidly spread all over the world and was recognized as a pandemic by the World Health Organization (WHO) on March 11, 2020 [2]. In 4 months, the disease was recognized in about 1,521,252 people and made 92,798 victims mainly in elderly and compromised patients. On an official report released on April 10, 2020, SARS-COV-2 carried a mortality rate around 6.1% compared to influenza that is supposed be around 1% [3]. All countries are encountering massive and dramatic problems in terms of prevention and sustainability of treatments for this disease which does not have a universally agreed therapeutic protocol. Current management of COVID-19 is mainly supportive, even though the medical literature has reported several rescue strategies which might minimize the mortality rate in those who have severe pulmonary complications. Hydroxychloroquine and azithromycin combination seems to be a valid possible therapeutic protocol [4] and is currently under urgent investigation. Unfortunately, the real challenge is represented by those cases where the severe form of SARS-COV-2 interstitial pneumonia occurs, with acute respiratory distress syndrome (ARDS) that might lead to fatal events [5]. The urgent need to find a treatment for such lifethreatening condition has led to off-label approaches based on the possible hypercytokinemia with multiorgan failure [6]. An experimental protocol using an anti-interleukin (IL)-6 receptor monoclonal antibody named tocilizumab (Actemra, Roche Pharma (Schweiz) Ltd, B2084B21) has given hope of a possible effective therapy. Tocilizumab was used as a rescue treatment in a series of patients affected by severe interstitial pneumonia by Zhang et al. [7] which observed an evident improvement in both systemic symptoms and the specific pulmonary impairment within a few days. P. Neri (&) F. Pichi The Eye Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE e-mail: [email protected]