Journal of Infection and Public Health (Aug 2021)

Efficacy of tocilizumab in patients with severe COVID-19: Survival and clinical outcomes

  • Abeer Al-Baadani,
  • Nazik Eltayeb,
  • Eid Alsufyani,
  • Salma Albahrani,
  • Shareefah Basheri,
  • Hawra Albayat,
  • Enas Batubara,
  • Sulafa Ballool,
  • Ayed Al Assiri,
  • Fahad Faqihi,
  • Ali B. Musa,
  • Asirvatham A. Robert,
  • Nisreen Alsherbeeni,
  • Fatehi Elzein

Journal volume & issue
Vol. 14, no. 8
pp. 1021 – 1027

Abstract

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Background: SARS-CoV-2 is associated with a severe inflammatory response contributing to respiratory and systemic manifestations, morbidity, and mortality in patients with coronavirus disease 2019 (COVID-19). Methods: Tocilizumab (TCZ) efficacy on mortality and length of hospital stay was retrospectively evaluated in patients who received TCZ and compared with that in controls with a similar severity of COVID-19. The primary endpoint was survival probability on day 28. The secondary endpoints included survival at day 14 and length of hospital stay. Results: Of the 148 patients included in the study, 62 received TCZ and standard of care, whereas 86 served as a control group and received only standard of care. The two groups were similar, although TCZ-treated patients were more likely to exhibit hypertension (46.7% vs. 29.8%), chronic kidney disease (14.5% vs. 1.1%), and high Charlson score (1.18 vs. 1.00; p = 0.006) and less likely to receive corticosteroid treatment (48.5% vs. 93.0%). TCZ was associated with lower mortality on both day 28 (16.1% vs. 37.2%, p = 0.004) and day 14 (9.7% vs. 24.4%, p = 0.022). The hospital stay was longer in the TCZ-treated than in the control group (15.6 ± 7.59 vs.17.7 ± 7.8 days, p = 0.103). Ten patients (16.0%) in the TCZ-treated group developed infections. Conclusion: TCZ was associated with a lower likelihood of death despite resulting in higher infection rates and a non-significant longer hospital stay.

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