ABSTRACT

Background

Tocilizumab, an inhibitor of the interleukin-6 receptor, may decrease the inflammatory response and control the symptoms of severe coronavirus disease 2019 (COVID-19), but the evidence is scarce.

Methods

This retrospective study included patients with severe COVID-19 requiring oxygen therapy who received tocilizumab in seven centers across Poland. We assessed on-treatment changes in clinical status and inflammatory markers.

Results

Twenty-eight patients were included (19 male), with a mean age of 61.7 ± 12.4 years. The mean time from symptom onset to the first tocilizumab dose was 10.5 ± 5.7 days. Clinical status improved within 24 hours in 11 (39%) patients, within one week in 23 (82%) patients, and within two weeks in 25 (89%); one (4%) patient showed no change and two (7%) patients died. Sixteen patients (57%) no longer needed oxygen therapy within a week (p < 0.001). The serum concentrations of C-reactive protein, procalcitonin, and fibrinogen decreased significantly (p ≤ 0.001). Lung changes improved in 21 (84%) patients within two weeks of treatment; 19 had minimal or no changes upon final examination.

Conclusions

Tocilizumab can control the symptoms of severe COVID-19 by reducing the inflammatory response and rapidly improves the clinical status in most patients.

中文翻译：

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重度COVID-19患者的Tocilizumab：一项回顾性多中心研究。

摘要

背景

白细胞介素6受体的抑制剂Tocilizumab可能会降低炎症反应并控制严重的冠状病毒病2019（COVID-19）的症状，但证据不足。

方法

这项回顾性研究纳入了需要氧疗的严重COVID-19患者，这些患者在波兰的七个中心接受了tocilizumab的治疗。我们评估了临床状态和炎症标志物的治疗变化。

结果

包括28名患者（19名男性），平均年龄为61.7±12.4岁。从症状发作到第一次托珠单抗的平均时间为10.5±5.7天。11例（39％）患者在24小时内改善了临床状况，23例（82％）患者在1周内改善了临床状况，25例（89％）在两周内得到了改善；一名（4％）患者无变化，两名（7％）患者死亡。16名患者（57％）在一周内不再需要氧气治疗（p <0.001）。C反应蛋白，降钙素原和纤维蛋白原的血清浓度显着降低（p≤0.001）。在治疗两周内，有21名（84％）患者的肺部改变得到改善；19岁的学生在最终检查时几乎没有变化。

结论

托珠单抗可通过减少炎症反应来控制严重COVID-19症状，并迅速改善大多数患者的临床状况。