The role of IL-6 receptor inhibitor treatment in critical patient monitoring with COVID-19
1Department of Anesthesiology and Reanimation, University of Health Sciences, İstanbul Kartal Dr. Lütﬁ Kırdar City Hospital, 34865 Istanbul, Turkey
2Department of Anesthesiology and Reanimation, University of Marmara, 34722 Istanbul, Turkey
DOI: 10.22514/sv.2021.068 Vol.17,Issue 3,May 2021 pp.174-180
Submitted: 17 February 2021 Accepted: 15 March 2021
Published: 08 May 2021
Objectives: The COVID-19 disease can manifest itself with acute respiratory distress syndrome, renal failure, and septic shock in critically ill patients. There are opinions that there is a correlation between high IL-6 levels and disease severity. In our intensive care unit, we evaluated the changes in the laboratory data and radiological involvement severity of our patients who underwent tocilizumab treatment and examined the appropriate laboratory parameter in the treatment follow-up and its effect on survival.
Methods: In the critical patient follow-up of COVID-19, 17 of the 23 patients treated with tocilizumab had a mortal course (Group 1) and the remaining 6 (Group 2) were. The C-reactive protein, lactate dehydrogenase, IL-6, D-dimer, procalcitonin, albumin, and ferritin values, which were routinely screened in our clinic on the day of tocilizumab treatment and the 5th day after, were recorded. Both the change between the two groups and the change between days 1 and 5 were analyzed.
Results: A total of 23 patients (55.35 ± 13.31 years) were included in the study. The computed tomography severity score assessed at the intensive care unit admission was statistically significantly higher in Group 2. The procalcitonin and lactate dehydrogenase values measured on day 5 after tocilizumab were significantly lower in Group 2. On the 5th day after treatment, the levels of C-reactive protein, ferritin, chest X-rays, IL-6 and D-dimer statistically significantly changed compared to the first day of the treatment. In correlation with the decrease in PCT as of the 5th day after tocilizumab administration, an increasing tendency was observed in 28-day survival.
Conclusion: This study demonstrated that tocilizumab treatment may positively contribute to the treatment by decreasing cytokine levels. PCT and LDH follow-up before and after treatment in critically ill patients who are receiving tocilizumab treatment can give an idea about survival.
Coronavirus; IL-6 receptor inhibitor; Intensive care units; Tocilizumab; LDH; PCT; CRP
Fulya Çiyiltepe,Ayten Saraçoğlu,Yeliz Bilir,Elif Akova Deniz,Elif Bombacı,Kemal Tolga Saraçoğlu. The role of IL-6 receptor inhibitor treatment in critical patient monitoring with COVID-19. Signa Vitae. 2021. 17(3);174-180.
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