Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort Study
Wael Hafez, Ahmed Abdelrahman
Antibiotics, doi:10.3390/antibiotics11081078
1) Background: The efficacy of tocilizumab in COVID-19 has been doubted. The study aimed to investigate factors affecting disease stability and response to tocilizumab among severe COVID-19 patients. (2) Methods: This was a cohort study of 70 severe COVID-19 patients at NMC Royal Hospital, UAE, from April to June 2020. (3) Results: Elderly patients and those with cardiovascular comorbidities had a higher risk of unstable COVID-19 (p = 0.025). Regarding tocilizumab therapy timing, compared to the critical group receiving tocilizumab, the unstable severe patients receiving tocilizumab had a significantly higher rate of improvement (86%). In contrast, the late critical subgroup showed a significantly increased mortality rate (52.9%). The risk for secondary infection and adverse events following tocilizumab was higher in the late critical group than in the unstable severe and early critical groups (p = 0.024 and p = 0.006, respectively). Therapeutic doses of anticoagulation and high-dose vitamin D were correlated with better outcomes than the prophylactic dose and the treatment dose of vitamin D (p < 0.001 and p = 0.07, respectively). (4) Conclusions: elderly patients and those with cardiovascular disease developed unstable COVID-19. Tocilizumab is a potentially effective choice against severe and critical COVID-19. Early tocilizumab administration combined with therapeutic dose anticoagulation and high vitamin D doses could improve the patients' outcomes.
Informed Consent Statement: This was a retrospective study; all Patients Identifiers were removed during the data collection process, with complete protection of patients' privacy. The study followed the Helsinki Declaration in terms of patient privacy. The Regional Research Ethics Committee, Department of Health, Abu Dhabi, UAE, reviewed and approved the study (Ref: ADHRTC-2021-178). As a retrospective study, informed consent was not required.
Conflicts of Interest: All authors declare no conflict of interest.
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'abstract': '<jats:p>(1) Background: The efficacy of tocilizumab in COVID-19 has been doubted. The study '
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'Regarding tocilizumab therapy timing, compared to the critical group receiving tocilizumab, '
'the unstable severe patients receiving tocilizumab had a significantly higher rate of '
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'tocilizumab was higher in the late critical group than in the unstable severe and early '
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'Tocilizumab is a potentially effective choice against severe and critical COVID-19. Early '
'tocilizumab administration combined with therapeutic dose anticoagulation and high vitamin D '
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