Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Feb:223:108631.
doi: 10.1016/j.clim.2020.108631. Epub 2020 Nov 12.

Effectiveness and safety of intravenous tocilizumab to treat COVID-19-associated hyperinflammatory syndrome: Covizumab-6 observational cohort

Hèctor Corominas  1 , Ivan Castellví  2 , Virginia Pomar  3 , Rosa Antonijoan  4 , Isabel Mur  5 , Laia Matas  3 , Ignasi Gich  6 , Natividad de Benito  3 , Ana Laiz  2 , Diego Castillo  7 , Laura Villamarin  8 , David Filella  3 , Ana Milena Millán  9 , María Ángeles Quijada  10 , Mireia Puig  11 , Jordi Casademont  3 , Pere Domingo  12
Affiliations
Observational Study

Effectiveness and safety of intravenous tocilizumab to treat COVID-19-associated hyperinflammatory syndrome: Covizumab-6 observational cohort

Hèctor Corominas et al. Clin Immunol. 2021 Feb.

Abstract

Although the starting event in COVID-19 is a viral infection some patients present with an over-exuberant inflammatory response, leading to acute lung injury (ALI) and adult respiratory distress syndrome (ARDS). Since IL-6 plays a critical role in the inflammatory response, we assessed the efficacy and safety of tocilizumab (TCZ) in this single-centre, observational study in all Covid-19 in-patient with a proven SARS-CoV-2 rapidly progressing infection to prevent ALI and ARDS. 104 patients with COVID-19 treated with TCZ had a lower mortality rate (5·8%) compared with the regional mortality rate (11%), hospitalized patient's mortality (10%), and slightly lower than hospitalized patients treated with our standard of care alone (6%). We found that TCZ rapidly decreased acute phase reactants, ferritin and liver release of proteins. D-Dimer decreased slowly. We did not observe specific safety concerns. Early administration of IL6-R antagonists in COVID-19 patients with impending hyperinflammatory response, may be safe and effective treatment to prevent, ICU admission and further complications.

Keywords: COVID-19; Cytokine release syndrome; IL-6R antagonist; SARS-CoV-2; Tocilizumab; Treatment.

PubMed Disclaimer

Conflict of interest statement

The study received no funding. The authors declare no conflict of interest for this manuscript.

All researchers played a role in study design, data collection, data analysis, data interpretation, or writing the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Figures

Unlabelled Image
Graphical abstract
Fig. 1
Fig. 1
Changes observed in LDH, Neutrophils, Lymphocytes as well as D-Dimer, Ferritin, CRP at baseline, before TCZ administration and before discharge.
Fig. 1
Fig. 1
Changes observed in LDH, Neutrophils, Lymphocytes as well as D-Dimer, Ferritin, CRP at baseline, before TCZ administration and before discharge.
Fig. 2
Fig. 2
Chest X-ray from a patient treated with iv tocilizumab a) baseline changes with few pleural bilateral infiltrates and few diffuse opacities b) progression of infiltrates, worsening of SpO2/FiO2 and PaO2/FiO2, together with positive clinical criteria of progression and increase of D-Dimer and IL-6 level. The patient received a single dose of 600 mg/iv TCZ, c) radiological improvement of lung infiltrates before discharge.
See this image and copyright information in PMC

Comment in

References

    1. Zhou P., Yang X.-L., Wang X.-G. Discovery of a novel coronavirus associated with the recent pneumonia outbreak in humans and its potential bat origin. bioRxiv. 2020;20
    1. Zhou F., Yu T., Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–1062. - PMC - PubMed
    1. Huang C., Wang Y., Li X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5. - DOI - PMC - PubMed
    1. Wang D., Hu B., Hu C. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–1069. - PMC - PubMed
    1. Zhang J.J., Dong X., Cao Y.Y. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020 doi: 10.1111/all.14238. - DOI - PubMed

Publication types

MeSH terms