Tocilizumab Treatment in Critically Ill Patients with COVID-19: A Retrospective Observational Study

https://doi.org/10.1016/j.ijid.2021.02.057

More tocilizumab-treated patients required mechanical ventilation (44/55, 80%) compared to non-treated patients (15/41, 37%; p<0.001). Of 55 patients treated with tocilizumab, 32 (58%) were on mechanical ventilation at the time of administration and 12 (22%) progressed to mechanical ventilation after treatment. Thirty of 44 (68%) treated ventilated patients were intubated within one day of tocilizumab. Fewer deaths were observed among tocilizumab-treated patients, both in the overall population (15% vs. 37%; p=0.02) and among the subgroup of patients requiring mechanical ventilation (14% vs. 60%; p=0.001). Secondary infections were not different between the two groups (tocilizumab: 31%, non-tocilizumab: 17%; p=0.16) and were predominantly related to invasive devices, such as urinary and central venous catheters. Tocilizumab treatment was associated with fewer deaths compared to non-treatment despite predominantly being used in patients with more advanced respiratory disease.

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