Tocilizumab therapy reduced intensive care unit admissions and/or mortality in COVID-19 patients

Introduction. - No therapy has yet proven effective in COVID-19. Tocilizumab (TCZ) in patients with severe COVID-19 could be an effective treatment. Method. - We conducted a retrospective case-control study in the Nord Franche-Comte Hospital, France. We compared the outcome of patients treated with TCZ and patients without TCZ considering a combined primary endpoint: death and/or ICU admissions. Results. - Patients with TCZ (n = 20) had a higher Charlson comorbidity index (5.3 [+/- 2.4] vs 3.4 [+/- 2.6], P = 0.014), presented with more severe forms (higher level of oxygen therapy at 13 L/min vs 6 L/min, P< 0.001), and had poorer biological findings (severe lymphopenia: 676/mm(3) vs 914/mm(3), P= 0.037 and higher CRP level: 158 mg/L vs 105 mg/L, P = 0.017) than patients without TCZ (n = 25). However, death and/or ICU admissions were higher in patients without TCZ than in the TCZ group (72% vs 25%, P= 0.002). Conclusion. - Despite the small sample size and retrospective nature of the work, this result strongly suggests that TCZ may reduce the number of ICU admissions and/or mortality in patients with severe SARS-CoV-2 pneumonia. (C) 2020 Elsevier Masson SAS. All rights reserved.