Title : Factors predicting poor outcomes of patients treated with tocilizumab for COVID-19 pneumonia: A retrospective study
Abstract:
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic is a significant global issue that has major implications for the healthcare system. Mortality rates of SARS-CoV-2 infection vary by geographic region and are associated with age, comorbidities, and vaccination status. Organ damage is caused by the cytokine release syndrome, which is important in the course of coronavirus disease-19 (COVID-19) patients. Innate and adaptive immune system stimulation in COVID-19 patients results in inappropriate cytokine release. Anti-IL-6 receptor antagonist tocilizumab is used to treat connective tissue diseases. In this single-center retrospective study of COVID-19 patients admitted between September 2020 and April 2022, we aimed to identify predictors of mortality and other unfavorable outcomes in patients treated with tocilizumab for COVID-19 pneumonia. Demographics, vaccination status against SARS-CoV-2, Charlson comorbidity index (CCI), laboratory data, and chest X-ray score were recorded on admission. In total, 174 subjects (121 males, mean age 62.43±13.47 years) fulfilling the inclusion criteria were identified. Among the 174 participants, 58 (33.3%) were intubated. The mortality rate was 35.1%. Non-survivors were older, mostly females, and had a higher CCI score. At the evaluation on admission, survivors presented with higher levels of alanine tranferase (ALT) and gamma glutamyl-transferase (GGT) and with a greater number of platelets (PLTs), while patients that were intubated were also older, mostly females, and had a higher CCI score (p<0.05). Age was identified as the only independent factor predicting mortality in the Cox proportional hazards multivariate regression analysis. By performing a sub-analysis regarding gender, we revealed that the value of PLTs was an independent factor predicting intubation and 90-day mortality in male patients, and the lymphocyte count was the only factor associated with intubation in female patients. This data could be used to to identify patient subpopulations responding to treatment with tocilizumab in prospective clinical trials.
Audience take-away:
- This presentation reveals factors associated with mortality in patients treated with tocilizuma for COVID-19
- Moreover, a separate sub-analysis regarding gender underlines the significant effect of dender in these patients.
- This data could be used to to identify patient subpopulations responding to treatment with tocilizumab in prospective clinical trials.
