Impact of tocilizumab on mortality and/or invasive mechanical ventilation requirement in a cohort of 206 COVID-19 patients

Int J Infect Dis. 2020 Oct;99:491-495. doi: 10.1016/j.ijid.2020.08.024. Epub 2020 Aug 13.

Abstract

Introduction: No therapy has proven to be effective yet to reduce mortality and/or invasive mechanical ventilation (IMV) requirement in COVID-19. Tocilizumab (TCZ) in patients with severe COVID-19 could be an effective treatment.

Methods: We conducted a retrospective case-control study in the Nord Franche-Comté Hospital, France. We compared the outcome of patients treated with TCZ and patients without TCZ considering a combined primary endpoint: mortality and/or IMV requirement.

Results: Thirty patients were treated with TCZ and 176 patients were treated without TCZ. TCZ was used in patients in critical condition (oxygen therapy flow at TCZ onset was 10.5 L/min and 14/30 patients had ≥ 50% lung involvement on CT scan) as a rescue treatment (8/30 patients who died were not admitted in USC in regard to their comorbidities). However, mortality and/or IMV requirement were lower in patients with TCZ than in patients without TCZ (27% vs 52%, p = 0.009).

Conclusion: Despite the small sample size in the TCZ group, this result suggests that TCZ reduces mortality and/or IMV requirement in patients with severe SARS-CoV-2 pneumonia. This notion needs to be confirmed and spread in the medical community.

Keywords: COVID-19; Invasive mechanical ventilation; Mortality; SARS-CoV-2; Tocilizumab.

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Betacoronavirus
  • COVID-19
  • Case-Control Studies
  • Comorbidity
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / mortality
  • Female
  • France
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / mortality
  • Respiration, Artificial
  • Retrospective Studies
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • tocilizumab