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Using Reference Reagents to Confirm Robustness of Cytokine Release Assays for the Prediction of Monoclonal Antibody Safety
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Clinical Predictors of Response to Tocilizumab: A Retrospective Multicenter Study

Selin Ercan1, Begüm Ergan1, Saliha Selin Özuygur1

  • 1Department of Pulmonology Medicine, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.

Turkish Thoracic Journal
|May 17, 2022
PubMed

Insights

Predictors of mortality in critically ill COVID-19 patients treated with tocilizumab include advanced age, high CALL and GRAM scores, elevated white blood cell counts, and mechanical ventilation. These factors indicate a worse prognosis.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Severe COVID-19 can lead to cytokine storm, worsening patient outcomes.
  • Tocilizumab, an interleukin-6 receptor antagonist, is a potential therapeutic for severe COVID-19.
  • Identifying predictors of mortality is crucial for managing critically ill patients.

Purpose of the Study:

  • To evaluate clinical predictors of mortality in critically ill COVID-19 patients receiving tocilizumab therapy.
  • To identify factors associated with worse prognosis in patients treated with tocilizumab for COVID-19.

Main Methods:

  • Retrospective cohort study conducted across 4 centers.
  • Inclusion of demographic, clinical, and laboratory data from medical records.
  • Primary endpoint: in-hospital mortality.

Main Results:

  • Mortality rate was 25.6% in 39 critically ill COVID-19 patients treated with tocilizumab.
  • Significant differences observed between survivors and non-survivors in age, CALL score, GRAM score, and white blood cell count.
  • Invasive mechanical ventilation at tocilizumab administration was associated with 100% mortality.

Conclusions:

  • Advanced age, elevated leukocyte count, higher CALL and GRAM scores, and need for invasive mechanical ventilation predict worse outcomes.
  • These factors are critical for assessing prognosis in COVID-19 patients receiving tocilizumab.
  • The PaO2/FiO2 ratio on day 7 post-therapy, not earlier, correlated with mortality.
Abstract

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