Abstract
Background: Tocilizumab has been proposed as an effective treatment for severe COVID-19. We aimed to investigate whether tocilizumab administration is associated with increased availability of serum iron which may possibly be associated with adverse effects on clinical outcomes.
Methods: We performed an observational, retrospective cohort study. We included adults, who were hospitalized in ICU with the diagnosis of severe COVID-19 infection eligible for tocilizumab treatment. Laboratory data including serum iron, ferritin, transferrin saturation, hemoglobin, and C-reactive protein levels of all patients were collected shortly before and 24 h, 48 h, and 72 h after tocilizumab administration.
Results: During the study period, 15 patients fulfilled the inclusion criteria and were eligible to receive tocilizumab treatment. Tocilizumab therapy was associated with a prominent increase in serum iron and transferrin saturation levels (26 ± 13 μg/dL and 15 ± 8% before treatment and 79 ± 32 μg/dL and 41 ± 15% 72 h after treatment, respectively, p < 0.001) and decrease in serum ferritin levels (1,921 ± 2,071 ng/mL before and 1,258 ± 1,140 ng/mL 72 h after treatment, p = 0.027).
Conclusion: Treatment of severe COVID-19 patients with tocilizumab is associated with a profound increase in serum iron and ferritin saturation levels along with a decrease in ferritin levels. This may represent an undesirable side effect that may potentiate viral replication.
Keywords: Anemia; COVID-19; Iron; Tocilizumab.
【저자키워드】 COVID-19, Anemia, iron, tocilizumab., 【초록키워드】 Treatment, therapy, Hospitalized, severe COVID-19, Tocilizumab, Diagnosis, C-reactive protein, ferritin, clinical outcomes, ICU, serum, Adults, viral replication, Transferrin, Patient, hemoglobin, retrospective cohort study, adverse effect, Severe COVID-19 Infection, Side effect, study period, inclusion criteria, ferritin levels, tocilizumab administration, serum ferritin level, effective, decrease, performed, collected, increase in, receive, eligible, severe COVID-19 patient, 【제목키워드】 iron, Effect,