The clinical outcome of Tocilizumab in the treatment of elderly patients with severe COVID-19 pneumonia

Background: Since the COVID-19 epidemic has caused serious public health problems and is connected to viral aggravation, steroids, which have anti-inflammatory effects, initially were used to manage severe cases marked by the cytokine storm. Tocilizumab may be able to reduce the hyperinflammatory reaction connected to the progressive respiratory failure brought on by SARS-CoV-2 by inhibiting the interleukin 6 receptor (IL-6R), one of the main cytokines involved in infection-induced cytokine storm.
Objective: To evaluate the efficiency of tocilizumab regarding clinical outcomes in elderly cases suffering from severe COVID-19 infection who have received standard-of-care treatment and tocilizumab in comparison with similar patients who have received standard-of-care treatment only.
Methods: A retrospective cohort study was done involving sixty patients enrolled on Ain Shams Geriatrics University Quarantine hospital with severe coronavirus infection from the 1st of June 2020 to the 31st of August 2020. Retrospective interpretation of medical reports was applied to gather data. The trial involved 60 patients older than 60 years with proof of SAR-CoV2 by nasopharyngeal swab classified into 2 groups: 30 patients who received the standard of care and tocilizumab (8mg/kg/dose) as a single dose and when clinical improvement does not occur, another dose was given >8hours following the initial dose and control group consisting of 30 patients who received standard of care treatment as recommended by WHO guidelines on treatment of Covid -19 2020, CDC recommendations of 2020, and Ain Shams University Guidelines 2020. Clinical outcomes were detected through assessment of symptoms, oxygenation, need for noninvasive and invasive ventilation, period of ICU stay, and rate of mortality.
Results: Studying the documents gathered from Ain Shams Geriatrics University hospital, a total of 60 patients with severe coronavirus pneumonia were included in this trial between the 1st of June 2020 to 31st of August 2020, which revealed that tocilizumab reduced inflammatory markers, enhanced blood oxygen levels of cases (p<0.001), and recede the demand for mechanical ventilator (p<0.001), but there was no direct significance on mortality rate and period of hospital stay.
Conclusion: Tocilizumab treatment at a dose of 8mg/kg/dose for senior patients with severe coronavirus pneumonia improved some clinical outcomes.