Clinical characteristics and early outcomes in patients with COVID-19 treated with tocilizumab at a United States academic center

摘要: Limited evidence is available to guide treatment of coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome 2 (SARS-CoV-2). A hyperinflammatory state mediated interleukin-6 (IL-6) has been proposed as a driver disease. Use IL-6 receptor inhibitor tocilizumab for COVID-19 was first reported in China, where case series described marked improvements inflammatory markers, fever, oxygen requirement, and outcomes following its administration. Here, we provide description tocilizumab-treated cohort patients with United States. We describe 11 from single academic medical center, nine (82%) whom were critically ill requiring mechanical ventilation an intensive care unit at time C-reactive protein levels decreased all (median 211.6 pre- vs. 19.7 mg/L 5 days post-tocilizumab [p=0.001]). When obtained before after therapy, wide variation seen baseline levels; post-dose concentrations consistently increased. In contrast prior reports, did not observe significant clinical improvement temperature or requirements most patients. Two discharged (18%), five remained critical condition (46%), one weaned off ventilator room air (9%), three died (27%). Our findings suggest that should be used caution highlight need data randomized controlled trials determine efficacy COVID-19.