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Potential Predictors of the Outcome of Tocilizumab Treatment in Patients with COVID-19-Associated Hyperinflammation

Shirkhan Amikishiyev1,2, Murat Bektaş1, Mehmet Güven Günver3

  • 1Department of Internal Medicine, Division of Rheumatology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.

Infectious Diseases & Clinical Microbiology
|July 14, 2025
PubMed

Insights

Predictors of tocilizumab treatment response in COVID-19-associated hyperinflammation (HIC) were identified. Key laboratory markers on Day 5 can indicate treatment efficacy, aiding in patient management during the pandemic.

Area of Science:

  • Critical Care Medicine
  • Immunology
  • Infectious Diseases

Background:

  • COVID-19-associated hyperinflammation (HIC) significantly increased mortality during the pandemic.
  • While anti-inflammatory therapies like tocilizumab improved survival, predicting treatment response remained a challenge.

Purpose of the Study:

  • To identify predictors of clinical outcomes in patients treated with tocilizumab for HIC.
  • To evaluate the utility of HIC scores for monitoring treatment response.

Main Methods:

  • Retrospective analysis of hospitalized adult COVID-19 patients treated with tocilizumab.
  • Analysis of dynamic laboratory parameters and calculation of HIC scores to assess disease severity and treatment response.

Main Results:

  • Among 150 patients receiving tocilizumab, 122 had HIC. Survivors showed reduced C-reactive protein (CRP) and decreasing HIC scores.
  • Non-survivors exhibited persistent high CRP, increasing neutrophil count, D-dimer, lactate dehydrogenase (LDH), troponin, and creatine kinase levels.

Conclusions:

  • Neutrophil count, CRP, D-dimer, LDH, troponin, and creatine kinase on Day 5 may predict tocilizumab efficacy.
  • The HIC score can be utilized for monitoring treatment response in HIC patients.
Abstract

Keywords:
COVID-19HIC scoreglucocorticoidshyperinflammationprognosisresponsetocilizumabtreatment

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