Tocilizumab is associated with reduction in inflammation and improvement in P/F ratio in critically sick COVID19 patients

IntroductionCoronavirus disease 2019 was initially detected in China and has been declared a global pandemic by World Health Organization on March 11, 2020. In the majority of patients, SARS{square}CoV{square}2 causes a mild to moderate illness characterized by fever and respiratory symptoms, with or without evidence of pneumonia. The recent studies suggest that anti-cytokine targeted therapies might be associated with benefit for patients with severe COVID-19 especially in improving respiratory failure. Tocilizumab, a monoclonal antibody against interleukin 6 (IL6) receptor, is associated with clinical benefit for COVID-19 patients as it inhibits IL6 and decreases inflammation. MethodsAs Tocilizumab has been an important part of our treatment and a strict criterion was followed to administer Tocilizumab, a retrospective study design used to assess the beneficial effects of Tocilizumab in improvement of ratio partial pressure of arterial Oxygen and fraction of inspired Oxygen (PaO2/FiO2 or P/F ratio) and C-reactive protein (CRP) in COVID19 patients has been done. 60 patients were taken for this study by using convenient sampling technique the data of demographics, laboratory results, and clinical outcomes i.e. improvement of respiratory failure depicted in the form of PF Ratio were obtained from the medical records, Statistical analysis was done with SPSS, version 21.0. ResultsSixty patients (47 males and 13 females) with COVID{square}19 were included in this study, the mean age of patients was 53.83 (14{square}81) years. After administration of Tocilizumab the lab parameters were changed as CRP decreased down to .40 (9.6{square}73) mg/L but other parameters were not affected. The PF ratio improved in COVID-19 patients after administration of Tocilizumab the median of PF Ratio before treatment was 108 (52{square}362) and improved up to 128 (37{square}406) after Tocilizumab therapy. ConclusionIn summary, Tocilizumab appears to be associated with improvement in P/F Ratio and CRP in COVID19 patients but other markers did not improve in response to Tocilizumab therapy in severely ill COVID-19 patients.