Background The first case of Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed in Wuhan, China in 2019. In the first half of 2020, this disease has already converted into a global pandemic. This study aimed to find that treatment of patients with COVID-19 pneumonia with Tocilizumab or steroids was associated with better outcomes. Objectives: To analyze the effectiveness of Tocilizumab in moderate to severe Covid-19 patients based on predefined assessment criteria . Study Settings : Single-center, Fatima Memorial Hospital, Lahore. Study design Quasi-experimental. Duration of study From May 12, 2020 to June 12, 2020. Patients & Methods: Sample size and technique Sample size was 93; 33 patients were kept in the experimental group, given Tocilizumab, 8 mg/kg intravenously or 162 mg subcutaneously, and the rest of the 60 patients were given corticosteroids, methylprednisolone 80 mg/day. Consecutive sampling. Failure of therapy was labeled when patients were intubated or died, and the endpoints were failure-free survival which was the primary endpoint, and overall survival secondary at the time of discharge. Results A total of 93 patients were enrolled, the Tocilizumab (TCZ) group (case) and Corticosteroid (CS) group (Control). The median age was 58 years (IQR-21), 37 (39.8%) patients with diabetes mellitus, 11 (11.8%) in the TCZ group, and 26 (28%) in the CS group. On the whole, the total median hospital stay in days was 7 with IQR (4), a total of 83 (89.2%) patients recovered successfully and discharged, 27 (29%) in the TCZ group and 56 (60.2%) in the CS group. Total 10 (10.8%) patients died, out of which 6 (6.5%) belonged to the TCZ group and 4 (4.3%) belonged to the CS group The median Oxygen requirement with IQR was 8 (9) in both the groups and in total as well, p-value (0.714). Conclusions Tocilizumab is a quite effective treatment option for critically sick patients of Covid-19 by reducing their oxygen requirement drastically and so the ICU stay, median hospital stay and so the mortality as well. Clinicals trials registration UIN # NCT04730323 Highlights • COVID-19 has shaken the world, leaving a huge impact on world’s economy. • First study in the country assessing effect of Tocilizumab comparing it with corticosteroids. • Tocilizumab, effectively reduces oxygen requirement, ICU stay, median hospital stay & mortality of COVID-19 sick patients. • Corticosteroids also emerged as better possible treatment option in the current armamentarium where novel drugs being tried. • Multiple studies on Tocilizumab conducted worldwide-showing promising results.
【저자키워드】 COVID-19, SARS-CoV-2, coronavirus, Tocilizumab, Cytokine storm syndrome, 【초록키워드】 Methylprednisolone, Treatment, Corticosteroids, therapy, Mortality, Trial, Pneumonia, drug, discharge, ICU, global pandemic, outcomes, Duration, survival, clinical, Patient, Effectiveness, Control, group, disease, moderate, patients, steroid, Hospital stay, acute respiratory syndrome, Intubated, Endpoint, failure, experimental group, median age, intravenously, Oxygen requirement, country, effective, setting, Wuhan, China, Result, enrolled, Sample, died, diagnosed, conducted, median, were given, reducing, sick, reduce, discharged, Total, assessment criteria, IQR, Memorial, patients died, patients with COVID-19, patients with diabete, subcutaneously, TCZ, the primary endpoint, 【제목키워드】 retrospective, single center, cytokine release, patients with COVID-19,