Impact of tocilizumab on clinical outcomes in severe covid-19 patients and risk of secondary infection: A case-control study

Authors : Buket ERTURK SENGEL, Serra OZEL, Fethi GUL, Can ILGIN, Elif TUKENMEZ TIGEN, Luftiye Nilsun ALTUNAL, Feyyaz KABADAYI, Uluhan SILI, Mehtap AYDIN, Zekaver ODABASI, Ismail CINEL, Volkan KORTEN

Pages : 112-119

Doi:10.5472/marumj.942700

View : 20 | Download : 8

Publication Date : 2021-05-31

Article Type : Research Paper

Abstract :Objective: This study aimed to identify the effect of tocilizumab insert ignore into journalissuearticles values(TCZ); on clinical outcomes in severe COVID-19 patients. Material and Methods: We included hospitalized COVID-19 patients with an initial WHO scale ≥4. We matched the patients with baseline characteristics by using propensity scores. Then, we selected patients with C-reactive protein levels above 30 and showing an upward trend. We assessed the effect of TCZ in patients on clinical outcomes by using Mann – Whitney U and Chi-square tests. Results: Of 200 patients who had an initial WHO scale ≥ 4, 42 insert ignore into journalissuearticles values(21%); were given TCZ in addition to standard of care insert ignore into journalissuearticles values(SOC);. Twentyfive patients insert ignore into journalissuearticles values(50%); needed mechanical ventilation insert ignore into journalissuearticles values(MV); in the TCZ group, compared with 35 insert ignore into journalissuearticles values(21%); of 158 patients with SOC insert ignore into journalissuearticles values(p<0.01);. Nineteen insert ignore into journalissuearticles values(45%); and 37 insert ignore into journalissuearticles values(23%); patients died in 30 days in these groups, respectively insert ignore into journalissuearticles values(p <0.01);. The secondary infection rate was significantly higher in the TCZ group insert ignore into journalissuearticles values(p=0.004);. However, no difference was observed in all these parameters in the propensity score-matched cohort insert ignore into journalissuearticles values(14 patients in TCZ and 14 in the SOC group); insert ignore into journalissuearticles values(p=0.45, 0.45, 1.0 respectively);. Conclusions: Tocilizumab does not provide a beneficial effect on MV requirement and mortality in severe COVID-19, and it does not increase the risk of secondary bacterial infection.
Keywords : COVID 19, IL 6, SARS CoV 2, Tocilizumab