Tocilizumab as a Therapeutic Agent for Critically Ill Patients Infected with SARS‐CoV‐2

Tocilizumab is an IL‐6 receptor antagonist with the ability to suppress the cytokine storm in critically ill patients infected with severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2). We evaluated patients treated with tocilizumab for a SARS‐CoV‐2 infection who were admitted between March...

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Bibliographic Details
Published in:Clinical and translational science 2021-11, Vol.14 (6), p.2146-2151
Main Authors: Petrak, Russell M., Skorodin, Nathan C., Van Hise, Nicholas W., Fliegelman, Robert M., Pinsky, Jonathan, Didwania, Vishal, Anderson, Michael, Diaz, Melina, Shah, Kairav, Chundi, Vishnu V., Hines, David W., Harting, Brian P., Sidwha, Kamo, Yu, Brian, Brune, Paul, Owaisi, Anjum, Beezhold, David, Kent, Joseph, Vais, Dana, Han, Alice, Gowda, Neethi, Sahgal, Nishi, Silverman, Jan, Stake, Jonathan, Nepomuceno, Jenie, Heddurshetti, Renuka
Format: Article
Language:English
Subjects:
African Americans
Age
Coronaviruses
COVID-19
Cytokine storm
Dehydrogenases
Dosage
Illnesses
Infectious diseases
Inflammation
Intubation
Length of stay
Mechanical ventilation
Monoclonal antibodies
Mortality
Pandemics
Patients
Severe acute respiratory syndrome coronavirus 2
Steroid hormones
Steroids
Variables
Ventilators
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Summary:Tocilizumab is an IL‐6 receptor antagonist with the ability to suppress the cytokine storm in critically ill patients infected with severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2). We evaluated patients treated with tocilizumab for a SARS‐CoV‐2 infection who were admitted between March 13, 2020, and April 16, 2020. This was a multicenter study with data collected by chart review both retrospectively and concurrently. Parameters evaluated included age, sex, race, use of mechanical ventilation (MV), usage of steroids and vasopressors, inflammatory markers, and comorbidities. Early dosing was defined as a tocilizumab dose administered prior to or within 1 day of intubation. Late dosing was defined as a dose administered > 1 day after intubation. In the absence of MV, the timing of the dose was related to the patient’s date of admission only. We evaluated 145 patients. The average age was 58.1 years, 64% were men, 68.3% had comorbidities, and 60% received steroid therapy. Disposition of patients was 48.3% discharged and 29.3% died, of which 43.9% were African American. MV was required in 55.9%, of which 34.5% died. Avoidance of MV (P = 0.002) and increased survival (P 
ISSN:1752-8054
1752-8062
DOI:10.1111/cts.12894