Administration Timing and Efficacy of Tocilizumab in Patients With COVID-19 and Elevated IL-6

Tocilizumab (TCZ), an interleukin-6 receptor antibody, has previously been used for treating patients with the coronavirus disease 2019 (COVID-19), but there is a lack of data regarding the administration timing of TCZ. This study aimed to evaluate the timing and efficacy of TCZ in the treatment of...

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Published in:Frontiers in molecular biosciences 2021-04, Vol.8, p.651662-651662
Main Authors: Li, Pan, Lu, Zhengmao, Li, Qiang, Wang, Zhenmeng, Guo, Yan, Cai, Chen, Wang, Shengyun, Liu, Peng, Su, Xiaoping, Huang, Yi, Dong, Yuchao, Qiu, Wenjuan, Ling, Yueming, Yarmus, Lonny, Luo, Fengming, Zeng, Li, Bai, Chong, Zhang, Wei
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coronavirus – COVID-19
cytokine storm
interleukin-6
Molecular Biosciences
SARS-CoV-2
tocilizumab (TCZ)
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container_title Frontiers in molecular biosciences
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creator Li, Pan
Lu, Zhengmao
Li, Qiang
Wang, Zhenmeng
Guo, Yan
Cai, Chen
Wang, Shengyun
Liu, Peng
Su, Xiaoping
Huang, Yi
Dong, Yuchao
Qiu, Wenjuan
Ling, Yueming
Yarmus, Lonny
Luo, Fengming
Zeng, Li
Bai, Chong
Zhang, Wei
description Tocilizumab (TCZ), an interleukin-6 receptor antibody, has previously been used for treating patients with the coronavirus disease 2019 (COVID-19), but there is a lack of data regarding the administration timing of TCZ. This study aimed to evaluate the timing and efficacy of TCZ in the treatment of patients with COVID-19. Laboratory-confirmed patients with COVID-19 with an elevated interleukin-6 (IL-6) level (>10 pg/ml) were offered TCZ intravenously for compassionate use. Clinical characteristics, laboratory tests, and chest imaging before and after the administration of TCZ were retrospectively analyzed. A total of 58 consecutive patients who met the inclusion criteria and with no compliance to the exclusion criteria were included. Of these 58 patients, 39 patients received TCZ treatment, and 19 patients who declined TCZ treatment were used as the control cohort. In the TCZ-treatment group, 6 patients (15.4%) were in mild condition, 16 (41.0%) were in severe condition, and 17 (43.6%) were in critical condition. After TCZ treatment, the condition of 27 patients (69.2%) improved and 12 (30.8%) died. Compared with the improvement group, patients in the death group had higher baseline levels of IL-6 ( = 0.0191) and procalcitonin (PCT) ( = 0.0003) and lower lymphocyte percentage (LYM) ( = 0.0059). Patients receiving TCZ treatment had better prognoses than those without TCZ treatment ( = 0.0273). Furthermore, patients with a baseline IL-6 level of ≥100 pg/ml in the TCZ-treatment group had poorer clinical outcomes than those with an IL-6 level of
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This study aimed to evaluate the timing and efficacy of TCZ in the treatment of patients with COVID-19. Laboratory-confirmed patients with COVID-19 with an elevated interleukin-6 (IL-6) level (&gt;10 pg/ml) were offered TCZ intravenously for compassionate use. Clinical characteristics, laboratory tests, and chest imaging before and after the administration of TCZ were retrospectively analyzed. A total of 58 consecutive patients who met the inclusion criteria and with no compliance to the exclusion criteria were included. Of these 58 patients, 39 patients received TCZ treatment, and 19 patients who declined TCZ treatment were used as the control cohort. In the TCZ-treatment group, 6 patients (15.4%) were in mild condition, 16 (41.0%) were in severe condition, and 17 (43.6%) were in critical condition. After TCZ treatment, the condition of 27 patients (69.2%) improved and 12 (30.8%) died. Compared with the improvement group, patients in the death group had higher baseline levels of IL-6 ( = 0.0191) and procalcitonin (PCT) ( = 0.0003) and lower lymphocyte percentage (LYM) ( = 0.0059). Patients receiving TCZ treatment had better prognoses than those without TCZ treatment ( = 0.0273). Furthermore, patients with a baseline IL-6 level of ≥100 pg/ml in the TCZ-treatment group had poorer clinical outcomes than those with an IL-6 level of &lt;100 pg/ml ( = 0.0051). 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subjects coronavirus – COVID-19
cytokine storm
interleukin-6
Molecular Biosciences
SARS-CoV-2
tocilizumab (TCZ)
title Administration Timing and Efficacy of Tocilizumab in Patients With COVID-19 and Elevated IL-6
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