Clinical course of severe COVID19 treated with tocilizumab and antivirals post‐allogeneic stem cell transplant with extensive chronic GVHD

Mirgh, Sumeet; Gokarn, Anant; Punatar, Sachin; Chichra, Akanksha; Singh, Anuj; Rajendra, Akhil; Babu Goli, Vasu; Trivedi, Bhakti; Joshi, Amit; Patkar, Nikhil; Tembhare, Prashant; Subramanian, P. G.; Shetty, Nitin; Chavan, Preeti; Bhat, Vivek; Gupta, Sudeep; Khattry, Navin

Recipients of allogeneic hematopoietic stem cell transplantation (allo‐HSCT) are an immunocompromised group who are likely to develop severe complications and mortality because of coronavirus disease 2019 (COVID‐19). We report here a 61‐year‐old male patient of primary myelofibrosis who underwent an allo‐HSCT 6 years earlier, had chronic graft‐versus‐host disease (cGVHD) involving the liver, lung, eyes, and skin, (with recurrent episodes of pulmonary infections) who developed severe COVID‐19. The patient was treated with tocilizumab, and a combination of lopinavir/ritonavir, ribavirin, interferon‐β1b. He was discharged after 31 days with full recovery. Tocilizumab, a humanized monoclonal antibody against IL6, has been shown to benefit respiratory manifestations in severe COVID19. However, this is first report, to our knowledge, of its use and benefit in a post HSCT recipient.