A Case Series of Severe Hospitalized COVID-19 Patients Treated with Tocilizumab and Glucocorticoids: A Report from Saudi Arabian Hospital

Authors

Salma AlBahrani¹, Jaffar A. Al-Tawfiq^{2, 3, 4, *,} , Abdulaziz R. Alshaer¹, Amal Shilash¹, Khalid Alswefy¹, Razan Salamah Al-Zayer¹, Amr Mohamed Abouelela¹

¹King Fahad Military Medical Complex, Dhahran, Saudi Arabia

²Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia

³Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

⁴Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

^*Corresponding author. Email: jaffar.tawfiq@jhah.com; jaltawfi@yahoo.com

DOI

10.2991/jegh.k.210112.001How to use a DOI?

Keywords

SARS-COV-2; COVID-19; Tocilizumab; therapy; steroid

Abstract

Background: The clinical spectrum of COVID-19 is variable and ranges from asymptomatic, mildly symptomatic, moderately severe and severe disease. A small proportion might develop severe disease and may have cytokine storm. One of the therapeutic options to treat such cases is Tocilizumab (TCZ). In this study, we present cases of severe COVID-19 treated with TCZ and glucocorticoids and discuss the treatment responses.

Methods: This is a retrospective observational study of severe COVID-19 cases treated with TCZ and glucocorticoids. The case series examined the characteristics and outcome of those patients.

Results: This study included 40 Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) confirmed patients who received TCZ and glucocorticoids. The mean age of the included patients was 57.55 (±Standard deviation 12.86) years. There were 34 (85%) males, 19 (47.5%) were obese (BMI >30), 13 (32.5%) over weight, and five (12.5%) normal weight. The mean days from positive SARS-CoV-2 polymerase chain reaction (PCR) test to admission was 1.641 (±3.2) days. Of the patients, 18 (45%) had diabetes mellitus, 14 (35%) had hypertension. The mean days from hospital admission to ICU was 1.8 (±2.6), 20 (50%) required mechanical ventilation, 39 (97.5%) had received prone position, seven (17.5%) had renal replacement therapy, 13 (32.5%) required inotropes, four (10%) had plasmapheresis, one (2.5%) had intravenous immunoglobulin, all patients received steroid therapy, and the majority 31 (77.5%) did not receive any anti-viral therapy. Of all the patients, six (15%) died, 28 (70%) were discharged and six (15%) were still in hospital.

Conclusion: The overall mortality rate was lower than those cited in meta-analysis. As our understanding of the COVID-19 continues, the approach and therapeutics are also evolving.

Copyright

© 2021 The Authors. Published by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Salma AlBahrani
AU  - Jaffar A. Al-Tawfiq
AU  - Abdulaziz R. Alshaer
AU  - Amal Shilash
AU  - Khalid Alswefy
AU  - Razan Salamah Al-Zayer
AU  - Amr Mohamed Abouelela
PY  - 2021
DA  - 2021/01/22
TI  - A Case Series of Severe Hospitalized COVID-19 Patients Treated with Tocilizumab and Glucocorticoids: A Report from Saudi Arabian Hospital
JO  - Journal of Epidemiology and Global Health
SP  - 233
EP  - 237
VL  - 11
IS  - 2
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.210112.001
DO  - 10.2991/jegh.k.210112.001
ID  - AlBahrani2021
ER  -