Tocilizumab – real world data from a third wave of the Covid-19 pandemic

Title: Tocilizumab – real world data from a third wave of the Covid-19 pandemic
Author(s): G. Kavanagh, E. O’Reilly, O. Ó Murchú, L. Walsh, H. Ibrahim, C. Raykha, K. Deasy, T.M. O’Connor, K. Bolger, M. Henry
Institution: Cork University Hospital, Wilton, Cork/ Mercy University Hospital, Cork/ Tipperary University Hospital
Poster: Click to view poster
Category: COVID 19
Abstract: There have been 124 million cases of coronavirus worldwide as of March 2021. Elevated IL-6 levels are linked with high viral loads, disease severity, and poor outcomes. Tocilizumab is a recombinant humanized anti-interleukin (IL)-6 receptor monoclonal antibody approved for the treatment of certain rheumatologic disorders and cytokine release syndrome.

This retrospective observational study aims to investigate the impact of Tocilizumab therapy on laboratory and radiological findings, oxygen requirements, need for mechanical ventilation, admission to an intensive care unit, hospital length of stay (LOS), and overall mortality.

53 patients from three hospitals were analysed. Median age was 63 year (55-69). 60% were male (n=32). There was a statistically significant reduction in fraction of inspired oxygen (Fi02) 3 and 7 days post tocilizumab (Figure 1). There was a statistically significant reduction in biochemical markers of infection – including CRP and ferritin. Mean ICU LOS was 12 days (range 2-72), mean hospital LOS was 23 days (6-75). The overall mortality was 38% (n=20).

Tocilizumab was associated with a significant decline in the biochemical markers of the hyperinflammatory response seen in COVID-19 pneumonia in this cohort.
Reduction in FiO2 and biochemical markers may indicate better outcomes. Larger multi-centre trials have shown improved outcomes, survival benefit and LOS.