Page 8 - Pulse@UM Issue 1/2020

The full genome of SARS-CoV-2 shares staggering 5,000 previously unknown CoV COVID-19 Trial: Tocilizumab
96.2% identity with betacoronaviruses species could be circulating insidiously
identified in the Rhinolophus affinis bats in in bats. However, the route of spillover Against Cytokine Storm In
the Yunnan province in China, indicating from bats to humans remains unclear, and
the bat-origin of SARS-CoV-2. Rhinolophus may involve domesticated mammals, and Severe Cases
spp. are abundant and diverse in Southern farmed or hunted wildlife. Tracking the
China and across Asia, the Middle East, (sero) prevalence, continuous evolution and
Africa and Europe. Intriguingly, prior to the movement of animal coronaviruses may help MALINEE NEELAMEGAM REENA A/P RAJASURIAR
...
COVID-19 outbreak, more than 500 species prevent the spillover of zoonotic viruses, (Department of Medicine) (Department of Medicine)
of CoV have already been identified in bats limiting the potential of another pandemic.
in China, many of which do not cause any ed by the Dean of University Malaya As the pandemic progresses, clinicians
disease symptoms in their natural hosts. LFaculty of Medicine, Professor Datuk are learning more about the underlying
It has also been speculated that up to a Dr Adeeba Kamarulzaman, clinicians and causes of progression to critical illness. In
researchers at University Malaya Medical these individuals, a cytokine storm, or an
Centre (UMMC), and three Ministry uncontrolled release of cytokines by the
of Health Malaysia hospitals (Sungai immune system results in respiratory failure
Buloh Hospital, Kuala Lumpur Hospital and the need for mechanical ventilation.
and Tuanku Jaafar Hospital, Seremban) A specific cytokine, interleukin-6 (IL-6)
will be conducting a clinical trial to is a critical component of the Covid-19
evaluate the efficacy of Tocilizumab for cytokine storm. Blocking IL-6 may stop
the treatment of severe cases of Covid-19. the progression of the disease to its most
critical stage. This is where investigators
In this randomized controlled clinical believe Tocilizumab, a drug specifically
trial, investigators aim to compare the designed to block the negative effects of
efficacy of intravenous Tocilizumab IL-6 can potentially reduce the severity
against Methylprednisolone, a high- of the illness. Covid-19 patients who
dose corticosteroid in approximately develop the cytokine storm syndrome at
310 hospitalised, severely ill Covid-19 UMMC have already shown encouraging
patients. Tocilizumab is conventionally results after receiving Tocilizumab.
used for the treatment of rheumatoid
arthritis and conditions of excessive The investigators strongly believe that this
inflammation. Patients in the study will be clinical trial has the potential to save many
randomized to receive either Tocilizumab lives. It will move to contribute to the urgent
or Methylprednisolone, both of which need for evidence based effective treatment
are known to inhibit inflammation. protocols for Covid-19 patients globally.

While approximately 80% of Covid-19
patients have mild to moderate symptoms

An illustration of SARS-CoV-2 binding to receptors and eventually recover, 15% of infected
individuals progress to severe Covid-19 ...
with another 5% developing critical illness
due to the infection. Death is reported
to be as high as 3% in Covid-19 patients.

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