Tocilizumab therapy reduced intensive care unit admissions and/or mortality in COVID-19 patients

Med Mal Infect. 2020 Aug;50(5):397-400. doi: 10.1016/j.medmal.2020.05.001. Epub 2020 May 6.

Abstract

Introduction: No therapy has yet proven effective in COVID-19. Tocilizumab (TCZ) in patients with severe COVID-19 could be an effective treatment.

Method: We conducted a retrospective case-control study in the Nord Franche-Comté Hospital, France. We compared the outcome of patients treated with TCZ and patients without TCZ considering a combined primary endpoint: death and/or ICU admissions.

Results: Patients with TCZ (n=20) had a higher Charlson comorbidity index (5.3 [±2.4] vs 3.4 [±2.6], P=0.014), presented with more severe forms (higher level of oxygen therapy at 13L/min vs 6L/min, P<0.001), and had poorer biological findings (severe lymphopenia: 676/mm3 vs 914/mm3, P=0.037 and higher CRP level: 158mg/L vs 105mg/L, P=0.017) than patients without TCZ (n=25). However, death and/or ICU admissions were higher in patients without TCZ than in the TCZ group (72% vs 25%, P=0.002).

Conclusion: Despite the small sample size and retrospective nature of the work, this result strongly suggests that TCZ may reduce the number of ICU admissions and/or mortality in patients with severe SARS-CoV-2 pneumonia.

Keywords: COVID-19; Intensive care unit; Mortality; SARS-CoV-2; Tocilizumab.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Betacoronavirus / drug effects
  • Betacoronavirus / immunology
  • COVID-19
  • Case-Control Studies
  • Comorbidity
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / pathology
  • Critical Illness / epidemiology
  • Critical Illness / mortality
  • Female
  • France / epidemiology
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Male
  • Middle Aged
  • Mortality
  • Pandemics
  • Patient Admission / statistics & numerical data*
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / pathology
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult

Substances

  • Antibodies, Monoclonal, Humanized
  • tocilizumab