ABSTRACT
In severe Covid-19 pneumonia, acute respiratory distress syndrome (ARDS) associated with cytokine storm is the leading cause of death. Tocilizumab was approved for chimeric antigen receptor T-cell therapy induced cytokine release syndrome and it may provide clinical benefit in these severe covid-19 pneumonia. In this retrospective cohort study, we evaluated patients with severe COVID-19 pneumonia admitted between May 2021 and June, 2021. Patients who were received tocilizumab during treatment, were enrolled for the study. Systemic steroids, hydroxychloroquine, and azithromycin were concomitantly used for the patients. The outcome was measured as an improvement in peripheral oxygen saturation by change in mode of oxygen therapy and improvement in laboratory parameters after tocilizumab administration. Out of 23 treated patients (18 Male, 5 Females), 19 patients received a single dose of tocilizumab and another four patients received two doses of it. Of these 23 patients, 3/3 with NRBM (non-rebreather mask) showed improvement and shifted to nasal cannula for oxygenation. 11/12 patients with NIV(non-invasive) showed improvement. 5/8 patients with invasive ventilation showed gradual improvement and shifted to NIV. A total of 4/23 (17%) patients didn’t show any improvement and died. Inflammatory markers like CRP, percentage of lymphocytes, and ferritin also showed significant improvement after administration of tocilizumab. Our study showed that in patients with severe COVID-19, tocilizumab was associated with significant improvement in clinical and laboratory parameters. These findings require further validation from ongoing clinical trials of Tocilizumab in COVID-19 patients.