Discussion
COVID-19 disease might show different responses to different therapy
because of differences in immune system function 5.
The previous study strongly supports a relationship between severe
COVID-19 mortality and
inflammation6.
Studies show that 5-10% of Covid-19 patients develop cytokine storm,
which can be fatal. Cytokine storm is observed in other conditions such
as infections, autoimmune disorders, and hematological malignancies.
When a cytokine storm occurs, the balance between pro-inflammatory and
anti-inflammatory cytokines is disturbed, causing tissue
damage7. Different cytokines are involved in different
etiologies. Specific cytokines in covid-19 help differentiate between
clinical intensities, mainly TNF-α, IL-1 β, IL-1Ra, IL-6, IL-7, IL-10,
and IP-108. TNF-α is a major pro-inflammatory cytokine
responsible for inflammation consequences in COVID-199. Thus, TNF-α contributes to the tissue inflammation
of COVID-19.
The reintroduction of oxygen may increase oxidative stress, which leads
to the enhancement of inflammation10. Thus, treatment
could be more effective before patients go on a ventilator. In the
present case, our covid-19 patient did not respond to the
immunosuppressive or antiviral drugs such as Methylprednisolone and
Remdesiver. The patient was treated with infliximab before chose of the
ventilator. A rapid disease remission and enhancement of SPO2 were found
after administration of infliximab.