https://orcid.org/0000-0001-7868-2708
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ABSTRACT
Background
Tocilizumab, an inhibitor of the interleukin-6 receptor, may decrease the inflammatory response and control the symptoms of severe coronavirus disease 2019 (COVID-19), but the evidence is scarce.
Methods
This retrospective study included patients with severe COVID-19 requiring oxygen therapy who received tocilizumab in seven centers across Poland. We assessed on-treatment changes in clinical status and inflammatory markers.
Results
Twenty-eight patients were included (19 male), with a mean age of 61.7 ± 12.4 years. The mean time from symptom onset to the first tocilizumab dose was 10.5 ± 5.7 days. Clinical status improved within 24 hours in 11 (39%) patients, within one week in 23 (82%) patients, and within two weeks in 25 (89%); one (4%) patient showed no change and two (7%) patients died. Sixteen patients (57%) no longer needed oxygen therapy within a week (p < 0.001). The serum concentrations of C-reactive protein, procalcitonin, and fibrinogen decreased significantly (p ≤ 0.001). Lung changes improved in 21 (84%) patients within two weeks of treatment; 19 had minimal or no changes upon final examination.
Conclusions
Tocilizumab can control the symptoms of severe COVID-19 by reducing the inflammatory response and rapidly improves the clinical status in most patients.
KEYWORDS:
Article highlights
The clinical status improved in 82% of patients with COVID-19 on continuous oxygen therapy within a week of the first tocilizumab dose.
Oxygen saturation levels improved significantly in patients with COVID-19 following tocilizumab treatment.
Following treatment, 84% of patients showed an improvement in lung changes upon imaging examination within ten weeks.
C-reactive protein, procalcitonin, and fibrinogen levels decreased, while lymphocyte and platelet counts increased, after tocilizumab treatment.
Good patient outcomes were associated with decreased interleukin-6 concentrations one week after tocilizumab treatment.
There were no significant safety issues related to tocilizumab administration.
Acknowledgments
The authors would like to acknowledge Rafał Szot (Proper Medical Writing) for providing writing and formatting support, and Julia Bates (Proper Medical Writing) for undertaking language editing and proofreading. The writing of this paper was supported by Roche Poland
Author contributions
All authors had full access to all the data in the study and take responsibility for its integrity and the accuracy of the analysis. RF and KT were responsible for the study concept and design. KT, AP, JSR, SS, AG, MP, JNO, TWL, DZM, JDK, AH, and RF were responsible for the acquisition, analysis, or interpretation of data. RF was responsible for drafting the manuscript and the statistical analysis.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Correction Statement
This article has been republished with minor changes. These changes do not impact the academic content of the article.