Abstract
Tocilizumab, can be used in the treatment of COVID-19 in patients developing cytokine storms. This study retrospectively evaluated patients treated with Tocilizumab. This study included 23 patients (17 men) admitted to the hospital and received Tocilizumab due to cytokine storms. The patients were categorized into three groups: "moderate, severe, and critical". Clinical outcomes after 7 days of hospitalization were classified as "death, disease aggravation, clinical stabilization, and clinical improvement". The mean age of the patients was 58±10.1 years. 52.2% of the patients were severely ill, and 47.8% were critically ill. After tocilizumab treatment, the mean lymphocyte count increased in all patients; the C-reactive protein levels dropped rapidly, except for one patient. After the first dose, the patients' fever dropped dramatically, and their oxygen support needs decreased. During the treatment, 82.6% of the patients were in the intensive care unit. At the end of the treatment, 56.5% had clinical improvement, 13% had clinical stabilization, and 4.3% had aggravation. Mortality occurred in 26.1%; 60.9% were discharged within a mean time of 19.14 ± 13.57 days after their treatment, and 18.2% of the critically ill and 91.7% of the severely ill patients recovered. Despite high rates of recovery and discharge after the tocilizumab treatment in the severely ill patients, more than half of the critically ill patients died. Early tocilizumab treatment resulted in a high survival rate and reduced the rates of progression to more critical states and mortality. Tocilizumab treatment should be given early in patients developing cytokine storms.
Highlights
Tocilizumab, can be used in the treatment of COVID-19 in patients developing cytokine storms
This study investigated the response rates of patients who were hospitalized due to COVID-19 and received intravenous TCZ treatment at our hospital, which is a tertiary research and training hospital, as well as factors affecting these response rates
Patients with elevated levels of C-reactive protein (CRP), ferritin and lactate dehydrogenase (LDH) and those who were not intubated had a better response to TCZ treatment [25]
Summary
Tocilizumab, can be used in the treatment of COVID-19 in patients developing cytokine storms. The vast majority of patients infected with SARS-CoV-2 have mild to moderate respiratory illness These people usually recover without any special treatment and without hospitalization. The elderly and those with underlying diseases such as cardiovascular diseases, diabetes, chronic respiratory disease and cancer are at a higher risk of developing severe illness [8]. In conditions such as various treatments, pathogens, cancers and autoimmune conditions, cytokine levels in the bloodstream may increase, and immune cell hyperactivation may develop. Cytokine storms can occur with the production of pro-inflammatory cytokines, including IL6, IL-1β, IL-2, IL-7, IL-8, IL-10, IL-17 and IFNγ [10,11]
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