Abstract :
Background and objectives: Patients with COVID-19 infection may develop respiratory
failure following cytokine release storm associated hyper-inflammatory state. Tocilizumab
(TCZ) can reduce this response by blocking IL-6 receptors and may improve survival. Here
we aimed to study the efficacy of TCZ in patients with moderate to severe COVID-19
pneumonia. Methods: In this retrospective observational study, all COVID-19 RT PCR
confirmed patients who received TCZ from May 1st through May 31st, 2020 at a tertiary
care teaching hospital in Gujarat, were analysed. The primary outcome was mortality on day
7 and day 28 after TCZ. Secondary outcomes were changes in laboratory and respiratory
parameters after TCZ. Results: Out of sixty-one treated patients (M: 45, F: 16, Median age
60 years), 75.4% had associated co-morbidity. The overall mortality was 31.05%(n=18)
while 68.96% (n=40) patients were discharged by day 28. Old age, high ferritin, high
baseline SOFA score, and low P/F ratio were important risk factors for mortality.
Polymorphonuclear leucocytosis and persistent higher CRP level after TCZ were associated
with reduced survival and may probe towards secondary bacterial infection. We observed
significant improvement in lymphocyte count, ferritin and CRP (
Keyword :
COVID-19, Mortality, P/F ratio, Tocilizumab