Open AccessTocilizumab as a Therapeutic Agent for Critically Ill Patients Infected with SARS‐CoV‐2
Author(s) -
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
Publication year - 2021
Publication title -
clinical and translational science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.303
H-Index - 44
eISSN - 1752-8062
pISSN - 1752-8054
DOI - 10.1111/cts.12894
Subject(s) - tocilizumab , medicine , dosing , cytokine release syndrome , intubation , mechanical ventilation , cytokine storm , severity of illness , anesthesia , covid-19 , disease , infectious disease (medical specialty)
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 < 0.001) was statistically associated with early dosing. Tocilizumab therapy was effective at decreasing mortality and should be instituted early in the management of critically ill patients with coronavirus disease 2019) COVID‐19).