Int J Biol Sci 2021; 17(8):2124-2134. doi:10.7150/ijbs.56952
Inflammation characteristics and anti-inflammation treatment with tocilizumab of severe/critical COVID-19 patients: A retrospective cohort study
1. Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 400038, People's Republic of China.
2. Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Army Medical University, Chongqing 400037, People's Republic of China.
3. Department of Thoracic Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing 400037, People's Republic of China.
# These authors contributed equally to this work.
* These authors jointly directed the project and share the corresponding authorship.
Hu Q, Xu Y, Xiang Y, Wang B, Yuan Z, Shan Y, Zhang W, Wu N, Xia T, Li C, Xie W, Jia X, Yu Z, Bai L, Li Y. Inflammation characteristics and anti-inflammation treatment with tocilizumab of severe/critical COVID-19 patients: A retrospective cohort study. Int J Biol Sci 2021; 17(8):2124-2134. doi:10.7150/ijbs.56952. Available from https://www.ijbs.com/v17p2124.htm
The efficacy of tocilizumab on the prognosis of severe/critical COVID-19 patients is still controversial so far. We aimed to delineate the inflammation characteristics of severe/critical COVID-19 patients and determine the impact of tocilizumab on hospital mortality. Here, we performed a retrospective cohort study which enrolled 727 severe or critical inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Huoshenshan Hospital (Wuhan, China), among which 50 patients received tocilizumab. This study confirmed that most recovered patients manifested relatively normal inflammation levels at admission, whereas most of the deceased cases presented visibly severe inflammation at admission and even progressed into extremely aggravated inflammation before their deaths, proved by some extremely high concentrations of interleukin-6, procalcitonin, C-reactive protein and neutrophil count. Moreover, based on the Cox proportional-hazards models before or after propensity score matching, we demonstrated that tocilizumab treatment could lessen mortality by gradually alleviating excessive inflammation and meanwhile continuously enhancing the levels of lymphocytes within 14 days for severe/critical COVID-19 patients, indicating potential effectiveness for treating COVID-19.
Keywords: COVID-19, Severe and critical patients, Inflammatory factors, Anti-inflammation treatment, Tocilizumab