Efficacy of tocilizumab treatment in COVID-19 patients with cytokine release syndrome

• Main Authors: Hayat Kumbasar, Nilgün Işıksaçan, Mehmet Hurşitoğlu, Semsi Karabela, Ozan Cemal Icacan, Melek Yalçın Mutlu, Faruk Karandere, Esra Canbolat Ünlü, Zuhal Yeşilbağ, Fatma Ekşi, Hakan Koçoğlu, Betül Erişmiş
• Format: Article
• Language: English
• Published: Journal of Surgery and Medicine 2021-03-01
• Series: Journal of Surgery and Medicine
• Subjects: covid-19; tocilizumab; sars-cov-2; cytokine release syndrome
• Online Access: https://dergipark.org.tr/en/pub/josam/issue/60662/876637

Background/Aim: Cytokine release syndrome, a potentially life-threatening condition in SARS‐CoV‐2 (COVID-19) patients, plays a critical role that may lead to the prioritization of tocilizumab (TCZ) in the treatment of this disease. We aimed to present our TCZ-treated SARS‐CoV‐2 patients’ data that might help and guide clinicians in dealing with this infectious disease in their daily practice and research. Methods: This is a retrospective multicenter cohort study from two Turkish pandemic centers. A total of 5165 patients’ data who were hospitalized due to SARS‐CoV‐2 pneumonia from March 16 to May 20, 2020 were screened and 72 patients treated with TCZ were included in the study. We evaluated patients' demographic data, laboratory and imaging studies, and clinical outcomes and the effect of TCZ treatment on patients' laboratory and clinical results. Results: O2 saturation levels significantly increased, and fever significantly decreased on the 5th day after TCZ therapy compared to before its initiation (P=0.001, P=0.010, respectively). The decrease in troponin-I, creatinine, LDH, fibrinogen, CRP, procalcitonin, CK, and ferritin levels after TCZ therapy were significant (P0.05 for all). Importantly, we found a significant increase in mortality rates in patients who received azithromycin, oseltamivir, and ascorbic acid treatments compared to those who did not receive those treatments (P