Clinical efficacy of tocilizumab treatment in severe and critical COVID-19 patients

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Jia Zeng1, Ming-Hui Xie2, Jing Yang2

  • 1Department of Aviation Disease, Naval Medical Center of PLA, Shanghai 200052, China.

World Journal of Clinical Cases
|September 21, 2020
PubMed

Insights

Tocilizumab effectively targets interleukin-6 (IL-6) in COVID-19 patients, improving symptoms in many. However, it does not fully suppress the cytokine storm, necessitating careful administration timing and supportive care.

Area of Science:

  • Immunology
  • Virology
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) respiratory failure is linked to cytokine storms, with interleukin-6 (IL-6) as a key mediator.
  • Tocilizumab, an IL-6 antagonist, is recommended for severe and critical COVID-19 patients.
  • The clinical effectiveness of tocilizumab in COVID-19 requires further investigation.

Purpose of the Study:

  • To evaluate the clinical efficacy of tocilizumab in mitigating the cytokine storm associated with COVID-19.

Main Methods:

  • Retrospective analysis of 19 severe/critical COVID-19 patients treated with tocilizumab.
  • Collected data included imaging, peripheral blood tests, biochemical profiles, coagulation, C-reactive protein (CRP), IL-6, and arterial blood gas analysis.

Main Results:

  • 13 out of 19 patients (68.4%) showed significant symptom improvement; 5 discharged, 8 transferred.
  • One patient had no response, one worsened, and 4 critical cases (21.1%) resulted in death.
  • Improved patients exhibited significant differences in lymphocyte count, CRP, lactic acid, oxygenation index, fibrinogen (FIB), and IL-6 levels.

Conclusions:

  • Tocilizumab demonstrates efficacy in targeting IL-6 in COVID-19 patients but does not completely abolish inflammation or the cytokine storm.
  • Optimal drug administration timing and adjuvant therapies are crucial for effective clinical management of COVID-19.
Abstract

Keywords:
COVID-19Cytokine stormInterleukin-6Tocilizumab

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