Int J Clin Pract. 2021 Feb 6:e14079. doi: 10.1111/ijcp.14079. Online ahead of print.
The treatment of severe cases of Covid-19 disease remains a dilemma so far, because there is no approved therapy for it. This study aimed to estimate the therapeutic efficacy of tocilizumab and its role in reducing the need for mechanical ventilation, length of hospital stay, mortality rate for these cases METHOD: The study included 25 adult patients with confirmed severe COVID-19 infection. Treatment of all patients followed Egyptian Ministry of Health COVID-19 protocol in addition to tocilizumab I.V. (400 -800 mg) as a single dose and then the dose was repeated after at least 12 h and up to 24 h from the previous dose. All laboratory and clinical parameters were assessed before and within 24hr after tocilizumab administration RESULTS: After receiving TCZ, all patients showed significantly lower median IL 6, LDH, CRP, ferritin , TLC at p<0.001 and D-Dimer at p=0.223 than their baseline levels. Also, the number of patients who required mechanical ventilation decreased from 11 to 8. Only 5 patients died after TCZ treatment. A moderate correlation was found between therapeutic failure and death outcomes and mechanical ventilation need at baseline. The median days of hospitalization (IQR) was 10 (6-16) CONCLUSION: Tocilizumab treatment in patients with severe COVID-19 is safe and has significant therapeutic effects and significant role in improvement of all laboratory parameters. Also plays significant role in the reduction of the length of stay in hospital and ICU, need for mechanical ventilation and mortality rate.