High Mortality Rate in Severe COVID-19 Despite Tocilizumab Administration: A Case Series

Cokorda Agung Wahyu Purnamasidhi, Ida Bagus Yorky Brahmantya, Saktivi Harkitasari, I Gusti Ngurah Mahaalit Aribawa, I Ketut Agus Somia

Abstract


Introduction: Tocilizumab is a potential therapeutic agent for modulating cytokine storms, a known cause of multiorgan failure and mortality in severe COVID-19. However, recent studies present conflicting results regarding its outcome and effectiveness. This study aims to assess the outcomes of severe COVID-19 patients treated with tocilizumab.

Objective: We report the mortality rate of patients with severe COVID-19 after tocilizumab administration.

Methods: A case series study involving 11 patients was conducted in the intensive care unit. Data on demographics, medical history, length of hospital stay, vital signs, laboratory and radiology examination, and drugs administered were collected. Statistical analysis used IBM SPSS version 17.

Results: The patient mortality rate reached 72.7%, with a median of two and 4.5 days of tocilizumab administration in patients who recovered and died, respectively. Comorbidities included hypertension (27.3%), type 2 diabetes mellitus (45.5%), and obesity (63.6%). Other therapies co-administered with tocilizumab include antibiotics, vasopressors, convalescent plasma, and remdesivir. Despite promising changes in laboratory parameters in almost every patient, radiological improvement was found in only 28.58% of patients.

Conclusion: This study highlights that tocilizumab administration in severe COVID-19 has a good safety profile, with no serious adverse effect observed, although a high mortality rate was observed even after tocilizumab administration in patients with severe COVID-19.


Keywords


COVID-19; critical care; tocilizumab; therapy

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DOI: 10.24815/jks.v24i3.37069

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