Tocilizumab-treated convalescent COVID-19 patients retain the cross-neutralization potential against SARS-CoV-2 variants

Although tocilizumab treatment in severe and critical coronavirus disease 2019 (COVID-19) patients has proven its efficacy at the clinical level, there is little evidence supporting the effect of short-term use of interleukin-6 receptor blocking therapy on the B cell sub-populations and the cross-neutralization of SARS-CoV-2 variants in convalescent COVID-19 patients. We performed immunological profiling of 69 tocilizumab-treated and non-treated convalescent COVID-19 patients in total. We observed that SARS-CoV-2-specific IgG1 titers depended on disease severity but not on tocilizumab treatment. The plasma of both treated and non-treated patients infected with the ancestral variant exhibit strong neutralizing activity against the ancestral virus and the Alpha, Beta, and Delta variants of SARS-CoV-2, whereas the Gamma and Omicron viruses were less sensitive to seroneutralization. Overall, we observed that, despite the clinical benefits of short-term tocilizumab therapy in modifying the cytokine storm associated with COVID-19 infections, there were no modifications in the robustness of cell and IgG responses to Spike antigens.

Automated summary

Although tocilizumab treatment has shown efficacy in severe COVID-19 patients, its short-term use does not affect B cell sub-populations and cross-neutralization of SARS-CoV-2 variants in convalescent COVID-19 patients. The study found that SARS-CoV-2-specific IgG1 titers were dependent on disease severity rather than tocilizumab treatment. Both treated and non-treated patients had strong neutralizing activity against ancestral and several variants of SARS-CoV-2, but weaker activity against the Gamma and Omicron variants. Overall, tocilizumab therapy did not modify the robustness of cell and IgG responses to Spike antigens.