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?:abstract
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Patients with coronavirus disease 2019 (COVID-19) may develop severe respiratory distress, thought to be mediated by cytokine release Elevated proinflammatory markers have been associated with disease severity Tocilizumab, an interleukin-6 receptor antagonist, may be beneficial for severe COVID-19, when cytokine storm is suspected This is a retrospective single-center analysis of the records of patients diagnosed with COVID-19 who received tocilizumab Outcomes, including clinical improvement, mortality and changes in oxygen-support at 24, 48, and 72 hours, and 7, 14, and 28 days post-tocilizumab, are reported Patients were evaluated by baseline pre-tocilizumab oxygenation status and changes in proinflammatory markers within 7 days post-tocilizumab are reported Sixty-six patients received tocilizumab at a mean dose of 724 mg (7 4 mg/kg), 3 7 days from admission At baseline, 53% of patients were on ventilation support and all had elevated proinflammatory markers, including c-reactive protein (CRP) Common comorbidities were diabetes mellitus (43%) and hypertension (74%) Most patients received concomitant glucocorticoids and hydroxychloroquine Seven days after tocilizumab, ten patients (15 2%) had clinical improvement in their oxygenation status, and there was a 95% decrease in CRP Within 14 days of treatment, 29% of patients had clinical improvement, 20% had minimal or no improvement, 17% worsened, 27% died, and 7% were transferred to an outside hospital Ultimately, 42% of all patients that received tocilizumab expired and 49% were discharged This study found limited clinical improvement in patients that received tocilizumab in the setting of severe COVID-19 Clinical trials are ongoing to further evaluate tocilizumab\'s benefit in this patient population
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