Factors affecting mortality in COVID-19 patients treated with tocilizumab

Abstract

The aim of our study was to evaluate the risk factors associated with mortality in COVID-19 patients. During March 2020 to March 2022, 136 patients who were treated with tocilizumab in the service and intensive care unit due to Covid-19 pneumonia confirmed by Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) were retrospectively analyzed. While the mean age of the surviving group (n:70) was 54.4 years, for the dying group (n:66) it was 67.4 years. There was no significant difference in terms of gender in the surviving and dying patient groups (p:0.761). The time from hospital ization to tocilizumab treatment was significantly shorter among survivors (p=0.004), while patients who received tocilizumab in the intensive care unit exhibited a higher mortality rate. While the median Charlson Comorbidity Index (CCI) score was 0 in the surviving patients, it was 2 in the dying group. It was found that a 1-unit increase in CCI increased the mortality rate 1.416 times. Age, CCI, neutrophil, neutrophil-lymphocyte ratio (NLR), urea, and C reactive protein (CRP) were found to be independent risk factors for mortality. Patients with high white blood cell, lactate dehydrogenase, troponin, d-dimer, and low lymphocyte, total protein, albumin, and glomerular filtration rates had higher mortality rate. CCI, white blood cell, NLR, urea, LDH, troponin, d-dimer, CRP, lymphocyte, GFR, albumin and total protein basal values can be used as risk factors for death from Covid-19 disease. In addition, early initiation of tocilizumab therapy may reduce mortality rates.