A retrospective evaluation of COVID-19 patients treated with Tocilizumab: who should be treated?

Abstract

Introduction: Tocilizumab, can be used in the treatment of COVID-19 in patients developing cytokine storms. This study retrospectively evaluated patients treated with Tocilizumab.

Methodology: This study included 23 patients (17 men) admitted to the hospital and received Tocilizumab due to cytokine storms. The patients were categorized into three groups: “moderate, severe, and critical”. Clinical outcomes after 7 days of hospitalization were classified as “death, disease aggravation, clinical stabilization, and clinical improvement”.

Results: The mean age of the patients was 58±10.1 years. 52.2% of the patients were severely ill, and 47.8% were critically ill. After tocilizumab treatment, the mean lymphocyte count increased in all patients; the C-reactive protein levels dropped rapidly, except for one patient. After the first dose, the patients' fever dropped dramatically, and their oxygen support needs decreased. During the treatment, 82.6% of the patients were in the intensive care unit. At the end of the treatment, 56.5% had clinical improvement, 13% had clinical stabilization, and 4.3% had aggravation. Mortality occurred in 26.1%; 60.9% were discharged within a mean time of 19.14 ± 13.57 days after their treatment, and 18.2% of the critically ill and 91.7% of the severely ill patients recovered.

Conclusions: Despite high rates of recovery and discharge after the tocilizumab treatment in the severely ill patients, more than half of the critically ill patients died. Early tocilizumab treatment resulted in a high survival rate and reduced the rates of progression to more critical states and mortality. Tocilizumab treatment should be given early in patients developing cytokine storms.