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Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients

Background: Tocilizumab (TCZ), a monoclonal antibody against the most prevalent cytokine interleukin-6 (IL-6), is an emerging therapeutic option for COVID-19 infections. The present study was undertaken to assess the therapeutic response of TCZ therapy in severely or critically ill COVID-19 patients...

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Autores principales: Bhandari, Sudhir, Rankawat, Govind, Singh, Ajeet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7991771/
https://www.ncbi.nlm.nih.gov/pubmed/33790504
http://dx.doi.org/10.5005/jp-journals-10071-23747
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author Bhandari, Sudhir
Rankawat, Govind
Singh, Ajeet
author_facet Bhandari, Sudhir
Rankawat, Govind
Singh, Ajeet
author_sort Bhandari, Sudhir
collection PubMed
description Background: Tocilizumab (TCZ), a monoclonal antibody against the most prevalent cytokine interleukin-6 (IL-6), is an emerging therapeutic option for COVID-19 infections. The present study was undertaken to assess the therapeutic response of TCZ therapy in severely or critically ill COVID-19 patients and its role as an effective modality of management. Methods: The present retrospective observational study included 30 admitted severely or critically ill COVID-19 patients, treated with TCZ therapy on behalf of raised IL-6 levels. The patients’ data concerning medical history, clinical manifestation, arterial blood gas analysis, mode of oxygenation, radiological imaging, and outcome were extracted from their medical records and compared pre- and post-TCZ infusion. Results: All patients of the study group had symptomatic presentations with a mean PaO(2)/FiO(2) (P/F) ratio of 205.41 before TCZ infusion. All patients had a raised IL-6 level (mean value 206.56 pg/mL) that was extremely elevated in 90% of patients. Infusion of TCZ dramatically reduced mean body temperature (100.78–99.32°F) and the requirement for supplemental oxygen (68–48%) and improved mean SpO(2) (86–89%) and mean P/F ratio (208–240) within 24 hours. Three patients on noninvasive ventilation were weaned off after TCZ infusion. Serum levels of IL-6 were raised initially but declined within 3–5 days of post-TCZ infusion. Conclusion: TCZ appears to be an effective therapeutic option in severely or critically ill COVID-19 patients with raised IL-6 levels. TCZ immediately improves the clinical status of patients by a probable mechanism of inhibition of cytokine storm and reduces COVID-19-related mortalities. How to cite this article: Bhandari S, Rankawat G, Singh A. Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients. Indian J Crit Care Med 2021;25(3):260–266.
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spelling pubmed-79917712021-03-30 Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients Bhandari, Sudhir Rankawat, Govind Singh, Ajeet Indian J Crit Care Med Original Research Background: Tocilizumab (TCZ), a monoclonal antibody against the most prevalent cytokine interleukin-6 (IL-6), is an emerging therapeutic option for COVID-19 infections. The present study was undertaken to assess the therapeutic response of TCZ therapy in severely or critically ill COVID-19 patients and its role as an effective modality of management. Methods: The present retrospective observational study included 30 admitted severely or critically ill COVID-19 patients, treated with TCZ therapy on behalf of raised IL-6 levels. The patients’ data concerning medical history, clinical manifestation, arterial blood gas analysis, mode of oxygenation, radiological imaging, and outcome were extracted from their medical records and compared pre- and post-TCZ infusion. Results: All patients of the study group had symptomatic presentations with a mean PaO(2)/FiO(2) (P/F) ratio of 205.41 before TCZ infusion. All patients had a raised IL-6 level (mean value 206.56 pg/mL) that was extremely elevated in 90% of patients. Infusion of TCZ dramatically reduced mean body temperature (100.78–99.32°F) and the requirement for supplemental oxygen (68–48%) and improved mean SpO(2) (86–89%) and mean P/F ratio (208–240) within 24 hours. Three patients on noninvasive ventilation were weaned off after TCZ infusion. Serum levels of IL-6 were raised initially but declined within 3–5 days of post-TCZ infusion. Conclusion: TCZ appears to be an effective therapeutic option in severely or critically ill COVID-19 patients with raised IL-6 levels. TCZ immediately improves the clinical status of patients by a probable mechanism of inhibition of cytokine storm and reduces COVID-19-related mortalities. How to cite this article: Bhandari S, Rankawat G, Singh A. Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients. Indian J Crit Care Med 2021;25(3):260–266. Jaypee Brothers Medical Publishers 2021-03 /pmc/articles/PMC7991771/ /pubmed/33790504 http://dx.doi.org/10.5005/jp-journals-10071-23747 Text en Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd. © Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
Bhandari, Sudhir
Rankawat, Govind
Singh, Ajeet
Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients
title Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients
title_full Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients
title_fullStr Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients
title_full_unstemmed Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients
title_short Tocilizumab: An Effective Therapy for Severely and Critically Ill COVID-19 Patients
title_sort tocilizumab: an effective therapy for severely and critically ill covid-19 patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7991771/
https://www.ncbi.nlm.nih.gov/pubmed/33790504
http://dx.doi.org/10.5005/jp-journals-10071-23747
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