ABSTRACT
COVID-19 treatment includes both antiviral agents and immunosuppressive and immunomodulatory medication for moderate and severe disease, which decrease systemic inflammation. Our objective was to evaluate tocilizumab, anakinra and corticosteroid effectiveness in a cohort of COVID-19 patients hospitalized in a tertiary care unit from Bucharest, Romania, during the second and third SARS-CoV-2 pandemic waves, by assessing the prediction variables for the length of hospital stay (LHS). We enrolled 330 consecutive patients, with a mean age of 58.2 +/- 14.8 years, 119 females (mean age 61.4 +/- 14.1 years) and 211 males (mean age 56.4 +/- 15 years). The prediction parameters for LHS were the treatment approach, older age and the presence of COPD, but were not associated with other significant comorbidities for COVID-19, such as obesity, diabetes, chronic renal failure or active malignancy. We found a significant difference in the mean LHS between patients who received tocilizumab and standard of care and patients treated with anakinra plus standard of care. Still, this difference was only seen in patients who required high concentration oxygen therapy (more than 5 L O-2/min). We suggest that, especially in non-critically-ill patients with a high oxygen therapy requirement, the administration of tocilizumab and standard of care is associated with a reduced length of hospital stay compared to the anakinra standard of care regimen.