The effects of tocilizumab on clinical and laboratory features of patients with severe COVID-19: a single center experience

Objective: Cytokine storm is considered as the immune hyperinflammatory process which may deteriorate the course of COVID-19 Interleukin (IL-6) inhibitors can be used in severe COVID-19 patients due to their anti-inflammatory and anti-immune effects We aimed to assess the therapeutic effect of tocilizumab (Actemra) in patients with severe COVID-19 pneumonia Methods: Overall, 1382 patients were admitted to a temporary hospital during July outbreak of COVID-19 Of these, 282 patients were hospitalized Baseline clinical, radiological and laboratory data were collected from patient records Laboratory markers prior to discharge were also collected Wilcoxon rank sum test was conducted to show the significance of change of laboratory markers Results: Eleven of the 282(3 9%) hospitalized patients who had severe pneumonia confirmed by either chest radiography (CXR) or computed tomography (CT) received tocilizumab (Actemra) Polymerase chain reaction (PCR) viral markers of COVID-19 were positive in three cases Hypoxemia and surrogate markers of cytokine storm improved after the prescription of tocilizumab (p=0 003 in all laboratory parameters) Two of the patients who received tocilizumab have been transferred to reference centers No mortality or adverse reactions case was registered Conclusion: Our observational study demonstrated significant improvement in oxygen saturation, reduction in inflammatory markers - leukocytosis, CRP and D-dimers and 83% recovery without need for mechanical ventilation and no mortality in patients with COVID-19 with severe multilobar bilateral pneumonia and CT score 3-4 receiving tocilizumab in addition to standard treatment