Authors: Atika Masood , Omair Farooq , Sadaf Waris , Muhammad Khan , Asim Mumtaz , Maleeha Aslam , Muhammad Usama

Abstract

Background and Objective: COVID-19 can cause severe acute respiratory distress syndrome. With deteriorating disease, most of the patients may require intensive care admission. This study was carried out to determine and evaluate the response of Tocilizumab with special reference to C-reactive protein (CRP) in critically ill patients presented to Farooq Hospital, West Wood Lahore.
Methods: This retrospective study included the data of 55 critically ill COVID-19 patients (respiratory rate ≥30, SpO2<93%, oxygen requirement ≥5L/min, PaO2/FiO2 ≤300 mmHg) admitted in Corona unit of Farooq Hospital West Wood Lahore, who were being treated with Tocilizumab alongwith standard treatment protocol between April 27 and June 21, 2020. The data has been retrieved from hospital records after taking appropriate permission and consent. Demographic, clinical features and serum CRP were recorded for each of them, before and after administration of Tocilizumab. Data analysis was done by Statistical Package for the Social Sciences (SPSS) version 22.0 and expressed as frequency and percentages.
Results: Out of 55 patients who were administered Tocilizumab, 72.7% survived whereas 27.3% died. There was higher median reduction of CRP levels in patients who survived (77.5 to 34.9 mg/L) as compared to those who died (65.5 to 45.3 mg/L). There was a statistically significant difference between CRP levels at the time of admission, 72 hours after Tocilizumab was administered (P<0.0001).
Conclusion: Tocilizumab administration might be helpful in reducing the complications of cytokine storm in patients with severe COVID-19 pneumonia.

Keywords: C-reactive protein, Pneumonia, COVID-19, Tocilizumab, Critically ill.