Clinical consequences of tocilizumab consumption time on COVID-19 patients

Abstract

Background & Aims: Studies have shown that treating COVID-19 with tocilizumab is associated with lower death risks and mechanical ventilation needs. However, the definite effectiveness of this drug based on the timing of its use is still controversial due to various findings. Some studies have shown that the timing of consumption can impact the drug’s effectiveness. Materials & Methods: This retrospective study was conducted on all COVID-19 patients who were treated with tocilizumab (Actemra) from August 2020 to August 2021 at Firoozabadi Hospital, Tehran. Demographic, laboratory, and clinical information of the patients were extracted from patient records. SPSS v22 software was used for data analysis. Results: In this study, we analyzed data from 344 patients with an average age of 57.31 ± 14.75 years (range: 19-95). The cohort included 186 men (54.06%) and 158 women (45.94%). Most patients (70.9%) received the drug between the second and fifth day of hospitalization. Overall, 104 patients (30.2%) died during their stay. Among those who received the medication twice, 38 out of 118 died, while 66 out of 224 died after a single dose. The highest mortality rate was observed in patients who received the drug after five days (39 deaths), and the age group of 60-95 had the highest percentage of deaths, totaling 58 (55.76%). Female patients also exhibited a higher mortality rate at 60.57% (63 deaths). Conclusion: Therefore, it seems that the best time to prescribe tocilizumab to COVID-19 patients is between the 2nd and 5th day of hospitalization. Additionally, the timing of drug consumption and the treatment process in elderly women with abnormal laboratory parameters should be evaluated more carefully.

Keywords

• actemra
• covid-19
• outcome
• tocilizumab
• treatment