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Highlights of clinical and laboratory parameters among severe COVID-19 patients treated with tocilizumab: a
Melahat Uzel Şener1, Tuğba Çiçek2, Ayperi Öztürk3
1MD. Physician, Pulmonary Medicine Department, Health Sciences University Faculty of Medicine, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
Insights
Tocilizumab treatment for COVID-19 cytokine release syndrome (CRS) showed that persistently high white blood cell and C-reactive protein levels indicate mortality. Age and low oxygen saturation are independent risk factors for mortality in these patients.
Area of Science:
- Medical research
- Immunology
- Infectious diseases
Background:
- Cytokine release syndrome (CRS) in COVID-19 patients is associated with high mortality.
- Tocilizumab is a treatment that suppresses CRS by inhibiting interleukin-6 (IL-6) signaling.
Purpose of the Study:
- To identify clinical and laboratory parameters predicting mortality in COVID-19 patients treated with tocilizumab.
- To analyze risk factors associated with tocilizumab treatment outcomes.
Main Methods:
- Retrospective observational study of 58 hospitalized COVID-19 patients treated with tocilizumab.
- Analysis of laboratory parameters (WBC, neutrophil, lymphocyte, ferritin, CRP) and clinical characteristics.
- Comparative analysis between surviving and deceased patient groups.
Main Results:
- No significant difference in initial WBC, neutrophil, lymphocyte, ferritin, or CRP levels between mortality and survival groups.
- Significantly lower WBC, lymphocyte, neutrophil, and CRP levels on days 3 and 5 post-tocilizumab in the survival group.
- Age and low oxygen saturation identified as independent risk factors for mortality.
Conclusions:
- Persistently elevated WBC, CRP, and neutrophil counts, along with low lymphocyte counts, may indicate mortality risk in COVID-19 patients receiving tocilizumab.
- Age and decreased oxygen saturation are independent predictors of mortality in this patient cohort.
Background:
Coronavirus disease 2019 (COVID-19) can cause cytokine release syndrome (CRS), which leads to high mortality rates. Tocilizumab suppresses CRS by blocking the signal transduction of interleukin-6 (IL-6).
Objective:
To evaluate the clinical and laboratory parameters associated with mortality among patients receiving tocilizumab treatment.
Design And Setting:
Retrospective observational study conducted in the chest disease departments of two different training and research hospitals in the center of Ankara, Turkey.
Methods:
Patients who were hospitalized and treated with tocilizumab in September 2020 were retrospectively analyzed. Their laboratory parameters and clinical characteristics were obtained from the hospital information system database. Comparative analyses were performed between the patients who died and the ones who survived.
Results:
A total of 58 patients who received tocilizumab treatment were included in this study, among whom 35 (60.3%) died. There was no difference between the mortality and survival groups in terms of white blood cell (WBC), neutrophil, lymphocyte, ferritin or C-reactive protein (CRP) levels detected on admission. WBC, lymphocyte, neutrophil and CRP levels measured on the third and fifth days after tocilizumab administration were found to be significantly lower in the survival group (P < 0.05). In multiple logistic regression analysis, age and oxygen saturation were determined to be independent risk factors for mortality.
Conclusion:
Persistently high WBC, CRP and neutrophil levels and low lymphocyte levels could be considered to be valuable indicators of mortality among COVID-19 patients treated with tocilizumab. Age and low oxygen saturation are independent risk factors for mortality among patients receiving tocilizumab treatment.
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