Timely treatment with tocilizumab likely to improve clinical outcomes in severe COVID-19 patients, finds study

Patients with severe COVID-19 are likely to have short-term mortality rates (death before 90 days of hospitalisation) between 35 percent to 62 percent, according to a study published in the journal JAMA Internal Medicine. In order to better manage the condition, these patients are given antiviral medications like remdesivir along with inflammation suppressing drugs to both - control the infection and prevent damage to body cells. A group of researchers at US’ Birmingham and Women’s Hospital have claimed that a rheumatoid-arthritis drug called tocilizumab can help reduce the risk of mortality in severe COVID-19 patients. The findings of the study are published in the same journal. Tocilizumab Tocilizumab is a monoclonal antibody against the cytokine interleukin-6 (IL-6). IL-6 is one of the major cytokines produced during the cytokine storm caused by the SARS-CoV2 virus. Preliminary studies have shown that administration of tocilizumab can improve clinical outcomes in COVID-19 patients. The drug is already approved and is used for the treatment of rheumatoid arthritis, an autoimmune disease that leads to joint inflammation and pain. The latest study For the latest study, the researchers took data from the STOP-COVID (Study of the Treatment and Outcomes in Critically Ill Patients With COVID-19) study, which is a multicenter cohort study that includes confirmed COVID-19 patients admitted in ICUs at 68 different hospitals across the US. A hypothetical target trial was then made by dividing about 3,924 critically-ill patients into those who took tocilizumab within the first two days of ICU admission and those who did not. All the patients were above the age of 18 (median age of 62) and were admitted to an ICU for a condition caused due to COVID-19 between 4 and 10 May. People who were enrolled in another placebo-controlled trial involving tocilizumab or other IL-6 inhibitors or those who were already admitted to the hospital a week (or more) before being transferred to the ICU were not included in the trial. The patients were then followed up with for 28 days (until 12 June, 2020) to see if they had been discharged, were still hospitalised or had died. Results  Here are some of the observations the researchers made in the study group:

• Of the 3,924 patients, 52.4 percent were discharged, 39.3 percent died and the rest were still hospitalised by the end of Day 28. Out of the patients who died, only 28.9 percent belonged to the tocilizumab group.
• Those who received tocilizumab had a median follow up of about 26 days while those who did not receive the drug had a median follow up of 27 days.
• The primary analysis showed that the estimated 30-day mortality in the tocilizumab group was at about 27.5 percent while that in the non-tocilizumab group, it was 37.1 percent.

The authors mentioned that therapies targeting cytokine storm, specifically IL-6 and other mediators of inflammation, can be used to target dysregulated inflammation in COVID-19 patients. However, since this was an observational analysis, more studies are still needed to confirm the findings. For more information, read our article on COVID-19.  Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.