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Background: In COVID-19 patients, increased IL-6 levels have been associated with poor disease prognosis. The use of tocilizumab shown to be effective in treating COVID-19 with varying success. This study aims to evaluate the effectiveness and safety of using a single dose of tocilizumab compared with multiple doses in critically ill COVID-19 patients.Methods:This study is a two-center, retrospective cohort, in which patients who received tocilizumab and were admitted to the ICU at two tertiary hospitals from March 1st, 2020, until January 31st, 2021were included. Patients were divided into two groups based on the number of doses of tocilizumab they received. Furthermore, we gathered additional data from the patients, such as but not limited to demographic data, vital signs, and laboratory markers. Multivariable logistic and generalized linear regression were used. We considered a P value of < 0.05 statistically significant. Results: Two hundred sixty-one patients were included in this study; 72.4% received a single dose of tocilizumab, while the rest (27.6%) had received multiple doses. Most of the patients were male, with an average age of 59.2. After adjusting for possible confounders, the ICU mortality within 30 days (OR 0.83; 95% CI, 0.33-2.08 p = 0.69) and in-hospital mortality (OR 0.64; 95% CI, 0.26-1.60 p = 0.35) were not significantly different between the two groups. On the flip side, patients who received multiple doses of tocilizumab have higher odds of secondary infection compared with a single dose (OR 3.06; 95% CI, 1.18-7.89 p = 0.02).Conclusion: Multiple doses of tocilizumab were not associated with a statistically significant difference in ICU and hospital mortality in critically ill patients infected with COVID-19. In contrast, it was associated with higher odds of secondary infections compared to a single dose. |
