The Effect of Tocilizumab on Inflammatory Markers in Survivors and Non-survivors of Severe COVID-19

OBJECTIVE To determine the effects of tocilizumab (TCZ) on inflammatory markers, laboratory indices; and short-term outcome in patients with severe COVID-19. STUDY DESIGN Cross-sectional analytical study. Place Duration Study: Hayatabad Medical Complex, Peshawar, Pakistan from 10th June till 31st August 2020. METHODOLOGY Fifty-four COVID-19 fulfilled inclusion criteria were included. All had received TCZ (4 mg/kg) addition to standard treatment. Serum C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer levels, full blood count, liver function tests (LFTs) checked before 24 hours after receiving TCZ. Short-term outcome, defined as survival at day 28, was determined hospital record/telephonic contact. Paired t-test employed assess statistical significance mean differences between pre- post-TCZ variables, considering a p-value <0.05 significant. RESULTS Overall, CRP 18.7 ± 10.7 10.2 8.6 mg/dl (p <0.001). It 18.0 10.3 8.8 (p=0.003) survivors; 19.4 11.4 8.7 (p=0.005) non-survivors, respectively. level decreased 12.5 23 12.2 µg/ml following (p=0.643); it 15.8 29.8 10.6 (p=0.612) 9.0 12.8 9.2 14.1 (p=0.961) There no significant LDH levels overall groups. The 28-day mortality 46.3%. CONCLUSION Tocilizumab results reduction CRP, while change D-dimers not substantial. markers did predict survival. Key Words: Tocilizumab, COVID-19, Biomarkers, Outcome, Mortality.