USE OF TOCILIZUMAB IN COVID-19 POSITIVE PREGNANT WOMEN

ABSTRACT

Background: Tocilizumab reduces the need for mechanical ventilation and improves survival in COVID-19 patients. There is limited evidence on Tocilizumab use in pregnant patients with COVID-19. Methods: Case series of pregnant patients with COVID-19 treated with Tocilizumab during hospitalisation between June to November 2021. Demographic data, maternal morbidity and neonatal outcomes were collected. Results: Ten pregnant patients received Tocilizumab. Six patients received a single dose of 800 mcg, 2 patients received a single dose of 600 mcg, and 2 patients received a double dose of 800 mcg and 600 mcg respectively. Three patients received Tocilizumab postpartum, with 6 receiving it in the second and third trimester (mean gestational age 29.5 +/- 3.9 weeks). Antenatal patients received Tocilizumab at a median of 84 (IQR 63) days before delivery. In five patients, there was a trend in improvement of respiratory rate following administration of Tocilizumab (Table1). Birth outcomes were available for 8 patients. There were no significant adverse maternal outcomes or opportunistic infections, with only 1 patient experiencing chorioamnionitis with no long term sequalae. All neonates were born with Apgar of 91 and 95. One infant was identified as having Lenticulostriatal vasculopathy and another was diagnosed with gastroenteritis, but no causative bacterial or viral organism was identified. One infant tested positive for COVID-19 on Day 5. Out of the 8 neonates who were born, 7 were breastfed and none of the neonates in this study experienced any adverse outcomes until discharge. Conclusions: Tocilizumab is efficacious and safe for COVID- 19 in pregnancy for the women and neonates. (Table Presented).