Eastern J Med. 2024; 29(3): 359-366 | DOI: 10.5505/ejm.2024.92499

Factors Affecting Mortality in COVID-19 Patients Treated with Tocilizumab

Osman Cüre¹, Kadir Ýlkkilic², Bayram Þen³, Medeni Arpa³, Esra Aydýn⁴, Ugur Avci⁵, Damla Tüfekçi⁵, Hatice Beyazal Polat⁶, Bayram Kýzýlkaya^6
1Recep Tayyip Erdogan University Medical Faculty Internal Medicine, Rheumatology, Rize
²Recep Tayyip Erdogan University Medical Faculty Internal Medicine, Hematology, Rize
³Recep Tayyip Erdogan University Training And Research Hospital, Biochemistry, Rize
⁴Recep Tayyip Erdogan University Medical Faculty Internal Medicine, Oncology, Ri̇ze
⁵Recep Tayyip Erdogan University Medical Faculty Internal Medicine, Endocrinology, Ri̇ze
⁶Recep Tayyip Erdogan University Training And Research Hospital, Internal Medicine, Rize

INTRODUCTION: The aim of our study was to evaluate the risk factors associated with mortality in COVID-19 patients who received tocilizumab therapy.
METHODS: 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.
RESULTS: 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 hospitalization 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.

DISCUSSION AND CONCLUSION: 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.

Keywords: Covid-19, Charlson comorbidity index, mortality, risk factors, tocilizumab

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