Large randomized clinical trials in severe Coronavirus Disease 2019 (COVID-19) patients have proven efficacy of intravenous tocilizumab. Our aim was to describe the laboratory parameters predicting in-hospital mortality of patients with tocilizumab administration in COVID-19 associated cytokine release syndrome (CRS).We evaluated high-dose (8 mg/kg) intravenous tocilizumab administration in severe and critically ill COVID-19 adult patients fulfilling predefined strict CRS criteria. A single-centre, prospective, observational cohort study was carried out among consecutive adult (≥18 years of age) in-patients with COVID-19 between April 1 and December 31, 2020. The primary endpoint was 28-day all-cause mortality. The changes in laboratory parameters from baseline on day 7 and 14 after administration of tocilizumab were analysed.In total, 1801 patients were admitted to our centre during the study period. One hundred and six patients received tocilizumab, and among them 62 (58.5%) required intensive care unit admittance while 25 (23.6%) deceased. At day 7 after tocilizumab administration, inflammatory markers (CRP, IL-6, ferritin) and lactate dehydrogenase (LDH) values were significantly lower among survivors. Subsequently, at day 14, differences of IL-6 and LDH levels has become more pronounced between subgroups. Restoration of absolute lymphocyte count (ALC) by day 7 and 14 was insufficient among patients who died.In our cohort, administration of high-dose tocilizumab for COVID-19 patients with CRS demonstrated clinical and sustained biochemical parameter improvement in 76.4%. In this patient population high and increasing LDH, IL-6, and low ALC levels had a predictive role for mortality.

中文翻译：

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预测用大剂量托珠单抗治疗的 COVID-19 相关细胞因子释放综合征成年住院患者死亡率的实验室参数。

2019 年严重冠状病毒病 (COVID-19) 患者的大型随机临床试验已证明静脉注射托珠单抗的疗效。我们的目的是描述预测在 COVID-19 相关细胞因子释放综合征 (CRS) 中使用托珠单抗的患者院内死亡率的实验室参数。我们评估了在重症和危重症 COVID 中使用高剂量 (8 mg/kg) 静脉注射托珠单抗-19 名成年患者符合预定义的严格 CRS 标准。在 2020 年 4 月 1 日至 12 月 31 日期间，在连续成年（≥18 岁）COVID-19 住院患者中进行了一项单中心、前瞻性、观察性队列研究。主要终点是 28 天全因死亡率. 分析了托珠单抗给药后第 7 天和第 14 天实验室参数相对于基线的变化。在研究期间，我们中心收治了 1801 名患者。106 名患者接受了托珠单抗治疗，其中 62 名 (58.5%) 需要进入重症监护病房，25 名 (23.6%) 死亡。在托珠单抗给药后第 7 天，幸存者的炎症标志物（CRP、IL-6、铁蛋白）和乳酸脱氢酶 (LDH) 值显着降低。随后，在第 14 天，亚组之间 IL-6 和 LDH 水平的差异变得更加明显。死亡患者在第 7 天和第 14 天恢复的绝对淋巴细胞计数 (ALC) 不足。在我们的队列中，对 COVID-19 CRS 患者使用大剂量托珠单抗后，临床和持续的生化参数改善率为 76.4%。在这个患者群体中，LDH、IL-6、