Efficacy and Safety of Tocilizumab Treatment in Tunisian Critically Ill COVID-19 Patients

Abstract

Background. COVID-19 is the major cause of serious acute respiratory complications, leading to strong perturbation of cytokine release and high levels of interleukin-6. In this work, we assessed the efficacy and safety of Tocilizumab in Tunisian patients with severe COVID-19. Materials and Methods. We enrolled in this retrospective study 255 critically ill patients in the intensive care unit of the military hospital of Tunis. These patients were categorized into a standard group (n = 148) and a Tocilizumab group (n = 107). Medical records were gathered and analyzed between September, 2020 and September, 2021. Results. No significant difference was detected in clinical and biological parameters at admission between the two studied groups. Interestingly, we revealed here a significant improvement in respiratory parameters as well as biological findings such as hemoglobin (p=0.001), platelets (p=0.005), CRP (p=0.0001), fibrinogen (p=0.0001), and creatinine (p=0.002). Regarding the Simplified Acute Physiology Score II and 28-day mortality, we showed a significant decrease of these two parameters following 48 hr of drug administration (p=0.0001, respectively). No significant difference between the two groups regarding complications except the renal failure and the need for renal replacement therapy, which are higher in the standard group as compared to patients treated with Tocilizumab (p=0.02; p=0.0001, respectively). Conclusions. Treatment with TCZ seems to be safe and effective in reducing the mortality rate in severe COVID-19 patients.