Clinical Management of Il-6 Driven Cytokine Storm Related to COVID-19 in a Patient with Recent Spinal Cord Stimulator Implants: A Case Report

INTRODUCTION: In the last months of 2019, the advent of a new virus called SARS-CoV-2 caused the spread of a pandemic disease, COVID-19, that has afflicted patients with chronic pain. CASE PRESENTATION: We describe a COVID-19 patient recently implanted with a spinal cord stimulator for FBSS, treated with Tocilizumab for cytokine storm complicating SARS-COV-2 infection. This patient developed a delayed hyperimmune reaction, causing an inflammatory reaction in the surgical pocket site, well treated with total remission. The total resolution of this local reaction occurred after the resolution of systemic COVID-19 infection by Tocilizumab. CONCLUSIONS: We discuss the balance between damage-associated molecular patterns (DAMPs) and pathogen-recognition receptors (PRRs), and the putative role of polymorphism in the IL-6/174 position of the promoter region.