Early Tocilizumab Administration was Associated with Decreased Mortality in COVID-19 Hospitalized Patients

Abstract

Abstract Background Coronavirus disease 2019 (COVID-19) is still prevalent at present. Tocilizumab as an effective treatment in COVID-19 is a humanized monoclonal antibody that binds to interleukin 6 (IL-6) receptor. But there is few articles that focused on the efficacious timing of tocilizumab administration. So we aimed to evaluate the efficacy of tocilizumab combined methylprednisolone in hospitalized COVID-19 patients. Methods This was a retrospective, observational cohort study. Intervention group selected patients received tocilizumab in addition to methylprednisolone treatment. Patients in the control group received standard of care treatment including methylprednisolone. The primary outcome was the patients’ clinical status, including recover rate at discharge and death rate in hospitalization. And the secondary outcome was the time from admission and methylprednisolone to tocilizumab use. Results In total, 112 patients included in this group (56 patients in the intervention group and 56 patients in the control group). The proportions of death during hospitalization was higher in the intervention group than those in the control group (p = 0.043). Both time from methylprednisolone to tocilizumab and time from admission to tocilizumab was much shorter in the recover group than that in the death group of intervention group (p = 0.004 and p = 0.008). Conclusions We found that tocilizumab was more used in COVID-19 hospitalized patients who have elevated systemic inflammation and lower Lymphocyte count. And early tocilizumab administration was associated with decreased mortality.