Response of Tocilizumab in Treating Severe to Critical COVID-19; Single-Centre Experience at a Tertiary Care Centre

Abstract

Objective: To study the effectiveness of Tocilizumab in reducing mortality in severely or critically ill patients.

Study Design: Quasi-experimental study

Place and Duration of Study: Mayo Hospital, Lahore Pakistan, from Dec 2020 to May 2021.

Methodology: The participants meeting the inclusion criteria of the study were allocated to an Experimental and a Control
Arm based on age and oxygen requirements. The Experimental-Group was given Tocilizumab plus standard care, while the
Control- Group received standard care only. Primary outcome was death, while secondary outcomes were the need for
invasive ventilation and length of hospital stay. Results were analyzed after 28 days.

Results: Among 81 patients, 60(74.1%) were males, 21(25.9%) were females. Of these, 44(54.3) received Tocilizumab plus
Standard Care, while 37(45.7%) received Standard Care only. Out of 44 patients from the Tocilizumab-Group, 21(47.7%)
survived, whereas, from 37 in the Standard Care-Group, 15(40.54%) survived at the end of 28 days. However, the difference in survival distributions between the two groups was not statistically significant (p=0.41).

Conclusion: Tocilizumab was found to have no significant impact on improving the chances of survival and reducing the risk of Invasive Ventilation in COVID-19 patients. A wider confidence interval, however, cannot rule out the possibility of some benefit or harm. Hence, further studies are needed on this subject.