BACKGROUND: Due to the lack of proven therapies, we evaluated the effects of early administration of tocilizumab for COVID-19. By inhibition of the IL-6 receptor, tocilizumab may help to mitigate the hyperinflammatory response associated with progressive respiratory failure from SARS-CoV-2. METHODS: A retrospective, observational study was conducted on hospitalized adults who received intravenous tocilizumab for COVID-19 between March 23, 2020 and April 10, 2020. RESULTS: Most patients were male (66.7%), Hispanic (63.3%) or Black (23.3%), with a median age of 54 years. Tocilizumab was administered at a median of 8 days (range 1-21) after initial symptoms and 2 days (range 0-12) after hospital admission. Within 30 days from receiving tocilizumab, 36 patients (60.0%) demonstrated clinical improvement, 9 (15.0%) died, 33 (55.0%) were discharged alive, and 18 (30.0%) remained hospitalized. Successful extubation occurred in 13 out of 29 patients (44.8%). Infectious complications occurred in 16 patients (26.7%) at a median of 10.5 days. After tocilizumab was administered, there was a slight increase in PaO2/FiO2 and an initial reduction in CRP, but this effect was not sustained beyond day 10. CONCLUSIONS: Majority of patients demonstrated clinical improvement and were successfully discharged alive from the hospital after receiving tocilizumab. We observed a rebound effect with CRP, which may suggest the need for higher or subsequent doses to adequately manage cytokine storm. Based on our findings, we believe that tocilizumab may have a role in the early treatment of COVID-19, however larger randomized controlled studies are needed to confirm this.
BACKGROUND: Due to the lack of proven therapies, we evaluated the effects of early administration of tocilizumab for COVID-19. By inhibition of the IL-6 receptor, tocilizumab may help to mitigate the hyperinflammatory response associated with progressive respiratory failure from SARS-CoV-2. METHODS: A retrospective, observational study was conducted on hospitalized adults who received intravenous tocilizumab for COVID-19 between March 23, 2020 and April 10, 2020. RESULTS: Most patients were male (66.7%), Hispanic (63.3%) or Black (23.3%), with a median age of 54 years. Tocilizumab was administered at a median of 8 days (range 1-21) after initial symptoms and 2 days (range 0-12) after hospital admission. Within 30 days from receiving tocilizumab, 36 patients (60.0%) demonstrated clinical improvement, 9 (15.0%) died, 33 (55.0%) were discharged alive, and 18 (30.0%) remained hospitalized. Successful extubation occurred in 13 out of 29 patients (44.8%). Infectious complications occurred in 16 patients (26.7%) at a median of 10.5 days. After tocilizumab was administered, there was a slight increase in PaO2/FiO2 and an initial reduction in CRP, but this effect was not sustained beyond day 10. CONCLUSIONS: Majority of patients demonstrated clinical improvement and were successfully discharged alive from the hospital after receiving tocilizumab. We observed a rebound effect with CRP, which may suggest the need for higher or subsequent doses to adequately manage cytokine storm. Based on our findings, we believe that tocilizumab may have a role in the early treatment of COVID-19, however larger randomized controlled studies are needed to confirm this.
Authors: Sarah Nadeem; Salima Saleem Aamdani; Bushra Ayub; Nashia Ali Rizvi; Fatima Safi Arslan; Russell Seth Martins; Maria Khan; Syed Faisal Mahmood Journal: Glob Health Epidemiol Genom Date: 2022-04-20
Authors: Ohoud Aljuhani; Khalid Al Sulaiman; Adel Alshabasy; Khalid Eljaaly; Abdulrahman I Al Shaya; Haytham Noureldeen; Mohammed Aboudeif; Bodoor Al Dosari; Amina Alkhalaf; Ghazwa B Korayem; Muneera M Aleissa; Hisham A Badreldin; Shmeylan Al Harbi; Abdullah Alhammad; Ramesh Vishwakarma Journal: BMC Infect Dis Date: 2021-11-01 Impact factor: 3.090
Authors: Elizabeth Leung; Ryan L Crass; Sarah C J Jorgensen; Sumit Raybardhan; Bradley J Langford; W Justin Moore; Nathaniel J Rhodes Journal: Clin Pharmacokinet Date: 2021-12-11 Impact factor: 6.447
Authors: Michael Behal; Brooke Barlow; Breanne Mefford; Melissa L Thompson Bastin; J Chris Donaldson; Melanie Laine; Brittany D Bissell Journal: Crit Care Explor Date: 2021-07-13