Treatment with Tocilizumab for Patients with Covid-19 Infections: A Case-series Study.

Mo, Yoonsun; Adarkwah, Obed; Zeibeq, John; Pinelis, Evgeny; Orsini, Jose; Gasperino, James

Tocilizumab (TCZ), a humanized monoclonal antibody targeting the interleukin-6 receptor, holds the potential for treating Corona Virus Disease 2019 (COVID-19) patients, particularly at high risk of cytokine storm syndrome. However, data regarding the clinical impact of treatment with TCZ in patients with COVID-19 are limited. This study was conducted to evaluate the safety and effectiveness of TCZ as an adjunct therapy for the treatment of severe COVID-19 infections. This is a retrospective, observational chart review of confirmed COVID-19 patients who received TCZ, along with other COVID-19 therapies. The outcomes of interest included changes in vital signs such as temperatures and laboratory biomarkers, the duration of mechanical ventilation, adverse events possibly associated with TCZ, and intensive care unit (ICU) and hospital lengths of stay. This study included 38 patients with an average age of 63 years (IQR: 48-70). The average dose of TCZ given was 519 ± 61 mg. The median values of C-reactive protein (CRP) significantly decreased following TCZ administration (189.9 vs. 54.8 mg/L, p = 0.003). Nineteen (73 %) of all febrile patients before the initiation of TCZ became fever free on the fourth day of TCZ treatment. Following TCZ treatment, 11 patients developed infections due to multidrug-resistant bacteria, and elevated liver transaminases were observed in 6 patients. The preliminary findings of this study suggested TCZ appeared to ameliorate COVID-19-related cytokine storm syndrome. However, large randomized controlled trials are needed to investigate whether treatment with TCZ is associated with better outcomes in COVID-19. This article is protected by copyright. All rights reserved.