Comparison of clinical outcomes of intensive care patients with COVID-19 pneumonia receiving and not receiving tocilizumab treatment

Abstract

Aim: In patients with Coronavirus disease 2019 (COVID-19) infection, a situation called cytokine storm and an increase in proinflammatory cytokines such as interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1 (IL-1) in the blood has been observed and it has been found that this is clinically related to the development of severe disease. Therefore, tocilizumab (TCZ) therapy that blocks IL-6 will reduce the immunological response and thus potentially harm caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study is to determine the effect of TCZ treatment on length of hospital stay, need for invasive mechanical ventilation and mortality in COVID-19 patients followed in the tertiary intensive care unit.Material and Method: This retrospective cross-sectional study was conducted among patients hospitalized with the diagnosis of COVID-19 pneumonia between 01.09.2020 and 01.01.21 in intensive care units. Data were analyzed and evaluated separately in patients who received and did not receive TCZ treatment. Patients older than 18 years of age, who were hospitalized for at least 24 hours with the diagnosis of COVID-19 pneumonia and needed ≥36 hours of oxygen therapy, were not referred to another health center, were included in this study. Pregnant and lactating women were not included in the study. Patients with missing at least one data in the parameters to be evaluated were excluded from the study. Patients treated with an IL-6 inhibitor other than TCZ were excluded.Results: After excluding patients who did not meet the inclusion criteria, 565 patients were included in the study. It was found that patients who received TCZ treatment after propensity score matching (PSM) had a significantly higher mean age (P<0.001) and lower obesity rates (P=0.002). There was no significant difference between the patients who received and did not receive TCZ treatment in terms of mechanical ventilation need, length of hospital stay and mortality (P=0.505, P=0.661, P=0.834).Conclusion: As a result of our research, it was seen that TCZ treatment did not affect the need for invasive mechanical ventilation, hospital and intensive care unit stay, and mortality.