Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort Study
(1) Background: The efficacy of tocilizumab in COVID-19 has been doubted. The study aimed to investigate factors affecting disease stability and response to tocilizumab among severe COVID-19 patients. (2) Methods: This was a cohort study of 70 severe COVID-19 patients at NMC Royal Hospital, UAE, fro...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/8/1078 |
| _version_ | 1827624028878143488 |
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| author | Wael Hafez Ahmed Abdelrahman |
| author_facet | Wael Hafez Ahmed Abdelrahman |
| author_sort | Wael Hafez |
| collection | DOAJ |
| description | (1) Background: The efficacy of tocilizumab in COVID-19 has been doubted. The study aimed to investigate factors affecting disease stability and response to tocilizumab among severe COVID-19 patients. (2) Methods: This was a cohort study of 70 severe COVID-19 patients at NMC Royal Hospital, UAE, from April to June 2020. (3) Results: Elderly patients and those with cardiovascular comorbidities had a higher risk of unstable COVID-19 (<i>p</i> = 0.025). Regarding tocilizumab therapy timing, compared to the critical group receiving tocilizumab, the unstable severe patients receiving tocilizumab had a significantly higher rate of improvement (86%). In contrast, the late critical subgroup showed a significantly increased mortality rate (52.9%). The risk for secondary infection and adverse events following tocilizumab was higher in the late critical group than in the unstable severe and early critical groups (<i>p</i> = 0.024 and <i>p</i> = 0.006, respectively). Therapeutic doses of anticoagulation and high-dose vitamin D were correlated with better outcomes than the prophylactic dose and the treatment dose of vitamin D (<i>p</i> < 0.001 and <i>p</i> = 0.07, respectively). (4) Conclusions: elderly patients and those with cardiovascular disease developed unstable COVID-19. Tocilizumab is a potentially effective choice against severe and critical COVID-19. Early tocilizumab administration combined with therapeutic dose anticoagulation and high vitamin D doses could improve the patients’ outcomes. |
| first_indexed | 2024-03-09T12:00:02Z |
| format | Article |
| id | doaj.art-db00b07abe054cd6a0ae0acd650050b0 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T12:00:02Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-db00b07abe054cd6a0ae0acd650050b02023-11-30T23:04:58ZengMDPI AGAntibiotics2079-63822022-08-01118107810.3390/antibiotics11081078Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort StudyWael Hafez0Ahmed Abdelrahman1NMC Royal Hospital, Abu Dhabi P.O. BOX 764659, United Arab EmiratesNMC Royal Hospital, Abu Dhabi P.O. BOX 764659, United Arab Emirates(1) Background: The efficacy of tocilizumab in COVID-19 has been doubted. The study aimed to investigate factors affecting disease stability and response to tocilizumab among severe COVID-19 patients. (2) Methods: This was a cohort study of 70 severe COVID-19 patients at NMC Royal Hospital, UAE, from April to June 2020. (3) Results: Elderly patients and those with cardiovascular comorbidities had a higher risk of unstable COVID-19 (<i>p</i> = 0.025). Regarding tocilizumab therapy timing, compared to the critical group receiving tocilizumab, the unstable severe patients receiving tocilizumab had a significantly higher rate of improvement (86%). In contrast, the late critical subgroup showed a significantly increased mortality rate (52.9%). The risk for secondary infection and adverse events following tocilizumab was higher in the late critical group than in the unstable severe and early critical groups (<i>p</i> = 0.024 and <i>p</i> = 0.006, respectively). Therapeutic doses of anticoagulation and high-dose vitamin D were correlated with better outcomes than the prophylactic dose and the treatment dose of vitamin D (<i>p</i> < 0.001 and <i>p</i> = 0.07, respectively). (4) Conclusions: elderly patients and those with cardiovascular disease developed unstable COVID-19. Tocilizumab is a potentially effective choice against severe and critical COVID-19. Early tocilizumab administration combined with therapeutic dose anticoagulation and high vitamin D doses could improve the patients’ outcomes.https://www.mdpi.com/2079-6382/11/8/1078COVID-19SARS-CoV-2tocilizumabdisease stabilityseveritymortality |
| spellingShingle | Wael Hafez Ahmed Abdelrahman Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort Study Antibiotics COVID-19 SARS-CoV-2 tocilizumab disease stability severity mortality |
| title | Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort Study |
| title_full | Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort Study |
| title_fullStr | Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort Study |
| title_full_unstemmed | Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort Study |
| title_short | Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort Study |
| title_sort | factors influencing disease stability and response to tocilizumab therapy in severe covid 19 a retrospective cohort study |
| topic | COVID-19 SARS-CoV-2 tocilizumab disease stability severity mortality |
| url | https://www.mdpi.com/2079-6382/11/8/1078 |
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