Outcomes of tocilizumab therapy in severe or critical COVID-19 patients : a retrospective cohort, single-centre study

Abdelnaby, Hassan and Aboelhassan, Wael and Al-Jarallah, Mohammed and Rajan, Rajesh and Dashti, Raja and Al Saber, Ahmad R. and Abd el-Saleem, Ahmed and Ashri, Islam and Abdullah, Mohammed and Mahmud Fouad, Ahmed (2021) Outcomes of tocilizumab therapy in severe or critical COVID-19 patients : a retrospective cohort, single-centre study. Tropical Medicine and International Health, 26 (12). pp. 1689-1699. ISSN 1365-3156 (https://doi.org/10.1111/tmi.13685)

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Abstract

Objectives: To assess the effectiveness and safety of tocilizumab, a humanised anti-interleukin-6 receptor antibody, in the treatment of critical or severe coronavirus disease 2019 (COVID-19) patients. Methods: This was a retrospective cohort study of severe or critical COVID-19 patients (≥18 years) admitted to one hospital in Kuwait. Fifty-one patients received intravenous tocilizumab, while 78 patients received the standard of care at the same hospital. Both groups were compared for clinical improvement and in-hospital mortality. Results: The tocilizumab (TCZ) group had a significantly lower 28-day in-hospital mortality rate than the standard-of care-group (21.6% vs. 42.3% respectively; p = 0.015). Fifty-five per cent of patients in the TCZ group clinically improved vs. 11.5% in the standard-of-care group (p < 0.001). Using Cox-proportional regression analysis, TCZ treatment was associated with a reduced risk of mortality (adjusted hazard ratio 0.25; 95% CI: 0.11–0.61) and increased likelihood of clinical improvement (adjusted hazard ratio 4.94; 95% CI: 2.03–12.0), compared to the standard of care. The median C-reactive protein, D-dimer, procalcitonin, lactate dehydrogenase and ferritin levels in the tocilizumab group decreased significantly over the 14 days of follow-up. Secondary infections occurred in 19.6% of the TCZ group, and in 20.5% of the standard-of-care group, with no statistical significance (p = 0.900). Conclusion: Tocilizumab was significantly associated with better survival and greater clinical improvement in severe or critical COVID-19 patients.

ORCID iDs

Abdelnaby, Hassan, Aboelhassan, Wael, Al-Jarallah, Mohammed, Rajan, Rajesh, Dashti, Raja, Al Saber, Ahmad R. ORCID logoORCID: https://orcid.org/0000-0001-9478-0404, Abd el-Saleem, Ahmed, Ashri, Islam, Abdullah, Mohammed and Mahmud Fouad, Ahmed;
  • Item type:Article
    ID code:78207
    Dates:
    Date
    Event
    31 December 2021
    Published
    3 October 2021
    Published Online
    20 September 2021
    Accepted
    Subjects:Science > Mathematics
    Department:Faculty of Science > Mathematics and Statistics
    Depositing user: Pure Administrator
    Date deposited:19 Oct 2021 12:21
    Last modified:11 Nov 2024 13:16
    URI:https://strathprints.strath.ac.uk/id/eprint/78207
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