Outcomes of tocilizumab therapy in severe or critical COVID-19 patients: A retrospective cohort, single-centre study.

Abstract

OBJECTIVES:

To assess the effectiveness and safety of tocilizumab, a humanised anti-interleukin-6 receptor antibody, in the treatment of critical or severe coronavirus disease 2019 (COVID-19) patients.

METHODS:

This was a retrospective cohort study of severe or critical COVID-19 patients (≥18 years) admitted to one hospital in Kuwait. Fifty-one patients received intravenous tocilizumab, while 78 patients received the standard of care at the same hospital. Both groups were compared for clinical improvement and in-hospital mortality.

RESULTS:

The tocilizumab (TCZ) group had a significantly lower 28-day in-hospital mortality rate than the standard-of care-group (21.6% vs. 42.3% respectively; p = 0.015). Fifty-five per cent of patients in the TCZ group clinically improved vs. 11.5% in the standard-of-care group (p < 0.001). Using Cox-proportional regression analysis, TCZ treatment was associated with a reduced risk of mortality (adjusted hazard ratio 0.25; 95% CI: 0.11-0.61) and increased likelihood of clinical improvement (adjusted hazard ratio 4.94; 95% CI: 2.03-12.0), compared to the standard of care. The median C-reactive protein, D-dimer, procalcitonin, lactate dehydrogenase and ferritin levels in the tocilizumab group decreased significantly over the 14 days of follow-up. Secondary infections occurred in 19.6% of the TCZ group, and in 20.5% of the standard-of-care group, with no statistical significance (p = 0.900).

CONCLUSION:

Tocilizumab was significantly associated with better survival and greater clinical improvement in severe or critical COVID-19 patients.

• Authors: Hassan Abdelnaby, Wael Aboelhassan, Mohammed Al-Jarallah, Rajesh Rajan, Raja Dashti, Kobalava D Zhanna, Ahmad R Alsaber, Ahmed Abd El-Aleem, Islam Ashry, Mohammed Abdullah, Ahmed Mahmoud Fouad
• Journal: Tropical medicine & international health : TM & IH (Trop Med Int Health) Vol. 26 Issue 12 Pg. 1689-1699 (12 2021) ISSN: 1365-3156 [Electronic] England
• PMID: 34601803 (Publication Type: Journal Article)
• Copyright: © 2021 John Wiley & Sons Ltd.

Chemical References

• Antibodies, Monoclonal, Humanized
• tocilizumab

Topics

• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal, Humanized (therapeutic use)
• COVID-19 (epidemiology)
• Cohort Studies
• Female
• Humans
• Kuwait (epidemiology)
• Male
• Middle Aged
• Retrospective Studies
• SARS-CoV-2
• Young Adult
• COVID-19 Drug Treatment