The Role of Convalescent Plasma and Tocilizumab in the Management of COVID-19 Infection: A Cohort of 110 Patients from a Tertiary Care Hospital in Oman

Authors

Faryal Khamis^{1, *,} , Ziad Memish^2, , Maher Al Bahrani^3, , Hamed Al Nummani^4, , Dana Al Raisi¹, Samata Al Dowaiki¹, Shabnam Chhetri¹, Fatma Al Fahdi^5, , Maha Al Yahyai⁶, Nenad Pandak^1, , Zakariya Al Bolushi¹, Zainab Alarimi^7, , Sabria Al Hashmi⁶, Issa Al Salmi^8, , Ibrahim Al-Zakwani^{9, 10,}

¹Department of Infectious Diseases, The Royal Hospital, Ministry of Health, P.O. Box: 1111, A’Seeb, Muscat, Oman

²Director Research & Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Al Faisal University, Riyadh, Kingdom of Saudi Arabia

³Department of Anesthesia and Critical Care, The Royal Hospital, Muscat, Oman

⁴Department of Pharmacy, The Royal Hospital, Muscat, Oman

⁵Department of Acute Medicine, The Royal Hospital, Muscat, Oman

⁶Department of Hematology, The Royal Hospital, Muscat, Oman

⁷Department of Blood Bank Services, Ministry of Health, Muscat, Oman

⁸Department of Nephrology, The Royal Hospital, Muscat, Oman

⁹Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman

¹⁰Department of Research, Gulf Health Research, Muscat, Oman

^*Corresponding author. Email: khami001@gmail.com

DOI

10.2991/jegh.k.201222.001How to use a DOI?

Keywords

COVID-19; convalescent plasma; tocilizumab; mortality; cytokine storm; Oman

Abstract

Aim: As Coronavirus Disease-2019 (COVID-19) pandemic continues to evolve, the search for safe and effective therapeutic interventions remain essential.

Methods: We conducted a retrospective cohort study on patients hospitalized with laboratory confirmed severe acute respiratory syndrome coronavirus-2 infection, comparing standard of care along with Convalescent Plasma with or without Tocilizumab (CP vs. CPT).

Results: A total of 110 patients were enrolled with an overall mean age of 50 ± 16 years. Patients on CPT were more likely to have had acute respiratory distress syndrome (77% vs. 42%; p < 0.001), sepsis (9.7% vs. 0; p = 0.036), chest X-ray abnormalities (71% vs. 44%; p = 0.004), intensive care unit admission (84% vs. 56%; p = 0.001) as well as being on mechanical ventilation (79% vs. 48%; p = 0.001). After CPT treatment, all measured inflammatory markers, except interleukine-6, showed an overall steady decline over time (all p-values <0.05) and the ventilatory parameters showed significant improvement of PaO₂/FiO₂ ratio from 127 to 188 within 7 days (p < 0.001). Additionally, 52% (32/62) of the patients had favorable outcome, either as improvement of ventilatory parameters or extubation within 14 days of hospitalization. However, mortality rate in those on CPT was higher than those who received CP alone (24% vs. 8.3%; p = 0.041).

Conclusion: In patients with severe COVID-19 infection, using tocilizumab with convalescent plasma is associated with improvement in inflammatory and ventilatory parameters but no effect on mortality. These findings require validation from randomized clinical trials.

Copyright

© 2020 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  - Faryal Khamis
AU  - Ziad Memish
AU  - Maher Al Bahrani
AU  - Hamed Al Nummani
AU  - Dana Al Raisi
AU  - Samata Al Dowaiki
AU  - Shabnam Chhetri
AU  - Fatma Al Fahdi
AU  - Maha Al Yahyai
AU  - Nenad Pandak
AU  - Zakariya Al Bolushi
AU  - Zainab Alarimi
AU  - Sabria Al Hashmi
AU  - Issa Al Salmi
AU  - Ibrahim Al-Zakwani
PY  - 2021
DA  - 2021/01/07
TI  - The Role of Convalescent Plasma and Tocilizumab in the Management of COVID-19 Infection: A Cohort of 110 Patients from a Tertiary Care Hospital in Oman
JO  - Journal of Epidemiology and Global Health
SP  - 216
EP  - 223
VL  - 11
IS  - 2
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.201222.001
DO  - 10.2991/jegh.k.201222.001
ID  - Khamis2021
ER  -