Tocilizumab in severe Covid-19 patients (clinical and laboratory outcome): A single centre retrospective observational study

Abstract

Background: Severe covid 19 disease is associated with multiorgan damage and mortality which is associated with dysregulated immune system with hyperactive inflammation, called as cytokine -release syndrome, for which IL 6 is considered to be the main culprit for the severity of the disease. Here we are observing the use of Tocilizumab, a monoclonal antibody against the IL 6 receptor in the treatment of severe COVID 19 patient. AIM: The aim of this study was to assess the role of tocilizumab in severe COVID -19 patients, clinical and laboratory outcome. Method: We did a retrospective, observational study on patients who were admitted in ICU with severe COVID-19 pneumonia who met the severity criteria were given Tocilizumab. Severity grading according to MoHFW were graded. The primary objective was to evaluate the effect of tocilizumab on mortality, length of hospital stay, trends of inflammatory markers and clinical progression of disease on day 10 of admission, compared with the similar group how were treated with standard treatment alone. Results: Out of (50 in tocilizumab group and 49 controls) patients, mortality was analysed showed 24% in tocilizumab group, 42.9% in control group. Mean length of hospital stay in tocilizumab and control group were compared i.e., 13.3 days and 14.27 days respectively. And there was significant reduction in inflammatory markers LDH, S FERRITIN, D DIMER, and CRP in tocilizumab group. Interpretation: Treatment with tocilizumab, might reduce the mortality in severe COVID-19 pneumonia patients. Since our study sample being small, a study with larger sample size may require predicting the outcome.