Late Onset Infectious Complications and Safety of Tocilizumab in the Management of COVID-19

https://doi.org/10.1002/jmv.26429

Seventy-four patients were included in each group. Seven-teen infections in the TCZ group (23%) and 6 (8%) infections in the control group occurred >48 hours after admission (p=0.013). Most infections were bacterial with pneumonia being the most common manifestation. Among patients receiving TCZ, LFT elevations were observed in 51%, neutropenia in 1.4%, and hypertension in 8%. The mortality rate among those that received TCZ was greater than the control (39% versus 23%, p=0.03). CONCLUSION: Late onset infections were significantly more common among those receiving TCZ. Combining infections and TCZ-related toxicities, 61% of patients had a possible post-TCZ complication. While awaiting clinical trial results to establish the efficacy of TCZ for COVID-19 related CRS, the potential for infections and TCZ related toxicities should be carefully weighed when considering use. 

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