CLINICAL EFFICACY OF TOCILIZUMAB IN THE TREATMENT OF SEVERE COVID-19 IN THE VOLYN REGION OF UKRAINE

Abstract

Treatment of coronavirus disease COVID-19 is currently unresolved. Whether it is advisable to use Tocilizumab (TM), whether it is effective and safe for patients with Covid-19 - this question remains open to physicians.The aim of the study: To evaluate the safety and therapeutic efficacy of TM on the course and prognosis of severe COVID-19 during treatment with standard treatment according to the National Protocol without antiviral therapy.Materials and methods: Retrospective cohort study of adult patients (≥18 years) with severe COVID-19, who were admitted to the infectious department №2 KP «Volyn Regional Clinical Hospital» from September 2020 to December 2020.The statistical analysis included a group of patients who received TM and recovered (n=42), a group of patients who recovered without TM (n=59), and a group of patients who received or did not receive TM and died (n=58). Statistical methods of interval estimation, null hypothesis according to U Mann-Whitney criteria, binomial criteria, and T-test for two independent dichotomous samples according to the Bernoulli scheme using SPSS Statistics 26 stepwise direct method LR were used for the analysis.Results: 77.7% of patients with severe COVID-19 who received TM recovered, however, based on the analysis of data from a cohort of patients with severe COVID-19 who did not receive TM, it was found that recovery did not depend on TM. Adverse events associated with TM were noted in 3.7%. It has been found that TM reduces recovery time in the hospital and reduces the risk of being admitted to the intensive care unit. The average value of C-reactive protein (СRP) in the group of recovering those who received TM - 114.1 mg/l, and elevated levels of Procalcitonin (PC) above normal by 59.52% with an average value of 0.35 ng / ml.Conclusions: The high statistical significance of the obtained results in terms of therapeutic efficacy and safety of TM makes it possible to implement the obtained results in wide practice for the use of this drug in the treatment of severe COVID-19.