(24 July 2020) Tocilizumab- associated with low mortality, and no major safety concerns in severe COVID-19 pneumonia

The objective of this work was to describe the clinical characteristics and predictors of major outcomes in patients treated with tocilizumab (TCZ) for severe COVID-19 pneumonia. From a cohort of 236 patients, 77 patients treated with TCZ were included (median age 62 years (IQR 53.0–72.0), 64.9% were males), 42.9% had Charlson index ≥3; hypertension (41.6%), obesity (34.7%), and diabetes (20.8%). Median follow-up was 83.0 days (78.0–86.5), no patient was readmitted. ICU admission was required for 42 (54.5%), invasive mechanical ventilation in 38 (49.4%) and 10 patients died (12.9% global, 23.8% at ICU admitted). After multivariate adjustment, TCZ response by BCRSS (OR 0.03 (0.01–0.68), p = 0.028), and Charlson index (OR 3.54 (1.20–10.44), p = 0.022) has been identified as independent factors associated with mortality. Median of hospital stay was 16.0 days (11.0–23.0); BCRSS, physician subjective and D-dimer response were associated with shorter hospitalization stay. In a Mediterranean cohort, use of tocilizumab for severe COVID-19 show 12.9% of mortality. Early TCZ-response by BCRSS and low comorbidity were associated with increased survival. Early TCZ-response was related to shorter median hospital stay.