Tocilizumab therapy reduced intensive care unit admissions and/or mortality in COVID-19 patients

Klopfenstein, Timothée; Zayet, Souheil; Lohse, Anne; Balblanc, Jean-Charles; Badie, Julio; Royer, Pierre-Yves; Toko, Lynda; Mezher, Chaouki; Kadiane-Oussou, N’dri Juliette; Bossert, Marie; Bozgan, Ana-Maria; Charpentier, Aline; Roux, Marie-Françoise; Contreras, Remy; Mazurier, Isabelle; Dussert, Pascale; Gendrin, Vincent; Conrozier, Thierry

Abstract Introduction. No therapy has yet proven effective in COVID-19. Tocilizumab (TCZ) in patients with severe COVID-19 could be an effective treatment. Method. We conducted a retrospective case-control study in the Nord Franche-Comté Hospital, France. We compared the outcome of patients treated with TCZ and patients without TCZ considering a combined primary endpoint: death and/or ICU admissions. Results. Patients with TCZ (n=20) had a higher Charlson comorbidity index (5.3 [±2.4] vs 3.4 [±2.6], p=0.014), presented with more severe forms (higher level of oxygen therapy at 13 L/min vs 6 L/min, p<0.001), and had poorer biological findings (severe lymphopenia: 676/mm3 vs 914/mm3, p=0.037 and higher CRP level: 158 mg/l vs 105 mg/l, p=0.017) than patients without TCZ (n=25). However, death and/or ICU admissions were higher in patients without TCZ than in the TCZ group (72% vs 25%, p=0.002). Conclusion. Despite the small sample size and retrospective nature of the work, this result strongly suggests that TCZ may reduce the number of ICU admissions and/or mortality in patients with severe SARS-CoV-2 pneumonia.