Author: Flisiak, Robert; Jaroszewicz, Jerzy; Rogalska, Magdalena; ÅapiÅ„ski, Tadeusz; Berkan-KawiÅ„ska, Aleksandra; Bolewska, Beata; Tudrujek-Zdunek, Magdalena; Kozielewicz, Dorota; Rorat, Marta; LeszczyÅ„ski, Piotr; KÅ‚os, Krzysztof; Kowalska, Justyna; Pabjan, PaweÅ‚; Piekarska, Anna; Mozer-Lisewska, Iwona; Tomasiewicz, Krzysztof; PawÅ‚owska, MaÅ‚gorzata; Simon, Krzysztof; Polanska, Joanna; ZarÄ™bska-Michaluk, Dorota
Title: Tocilizumab Improves the Prognosis of COVID-19 in Patients with High IL-6 Cord-id: fj6pjtg0 Document date: 2021_4_9
ID: fj6pjtg0
Snippet: Despite direct viral effect, the pathogenesis of coronavirus disease 2019 (COVID-19) includes an overproduction of cytokines including interleukin 6 (IL-6). Therefore, tocilizumab (TOC), a monoclonal antibody against IL-6 receptors, was considered as a possible therapeutic option. Patients were selected from the SARSTer database, containing 2332 individuals with COVID-19. Current study included 825 adult patients with moderate to severe course. Analysis was performed in 170 patients treated with
Document: Despite direct viral effect, the pathogenesis of coronavirus disease 2019 (COVID-19) includes an overproduction of cytokines including interleukin 6 (IL-6). Therefore, tocilizumab (TOC), a monoclonal antibody against IL-6 receptors, was considered as a possible therapeutic option. Patients were selected from the SARSTer database, containing 2332 individuals with COVID-19. Current study included 825 adult patients with moderate to severe course. Analysis was performed in 170 patients treated with TOC and 655 with an alternative medication. The end-points of treatment effectiveness were death rate, need for mechanical ventilation, and clinical improvement. Patients treated with TOC were balanced compared to non-TOC regarding gender, age, BMI, and prevalence of coexisting conditions. Significant effect of TOC on death was demonstrated in patients with baseline IL-6 > 100 pg/mL (hazard ratio [HR]: 0.21, 95% confidence interval [CI]: 0.08–0.57). The best effectiveness of TOC was achieved in patients with a combination of baseline IL-6 > 100 pg/mL and either SpO2 ≤ 90% (HR: 0.07) or requiring oxygen supplementation (HR: 0.18). Tocilizumab administration in COVID-19 reduces mortality and speeds up clinical improvement in patients with a baseline concentration of IL-6 > 100 pg/mL, particularly if they need oxygen supplementation owing to the lower value of SpO2 ≤ 90%.
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