Investigation of the Effectiveness of Tocilizumab on COVID-19 Patients: A Retrospective Study

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Background: Tocilizumab (TCZ), an interleukin-6 receptor inhibitor, has been considered a potential treatment for severe COVID-19 cases. However, data on its effectiveness remain limited. Objectives: This study aims to evaluate the outcomes of using TCZ in patients with severe COVID-19 during the fifth wave of the pandemic. Methods: This retrospective cohort study was conducted on 114 patients with severe COVID-19 who were hospitalized in the ICU at Sayyad Shirazi Hospital in Gorgan, Iran, during the fifth wave. The patients were divided into two groups: 57 received TCZ along with standard treatment (remdesivir and corticosteroids), while 57 received only standard treatments. Results: The mean age of the participants was 53.02 ± 17.29 years, with 54.4% being female. The mean length of hospitalization was 20.16 ± 17.30 days. Statistical analysis showed no significant differences regarding age (P = 0.34), gender (P = 0.25), or length of hospitalization (P = 0.84). Additionally, 43.9% of the participants had underlying health conditions, with no significant difference in their distribution (P = 0.70). The intubation rate was 3.5% in the TCZ group compared to 5.3% in the control group, with no significant association between the two groups (P = 0.64). Mortality rates were 47.4% (27 patients) in the TCZ group and 56.1% (32 patients) in the control group, with statistical analysis revealing no significant difference between the two groups (P = 0.34). However, in patients aged 60 years and older, the mortality rate was significantly higher in the control group than in the TCZ group (P = 0.03). Conclusion: The use of TCZ in severe COVID-19 patients hospitalized in the ICU was associated with a reduced mortality risk among patients aged 60 years and older.

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