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Purpose <p>Tocilizumab reduces inflammation during cytokine storms, a key driver of acute respiratory distress syndrome (ARDS) in COVID-19. This study evaluates the impact of tocilizumab timing on outcomes in severe to critically ill COVID-19 patients.</p> Methods <p>This prospective study included patients with severe to critical COVID-19 pneumonia. Patients were divided into two groups: Group 1 received tocilizumab within 10&#xa0;days of symptom onset along with standard care, while Group 2 received it after 10&#xa0;days.</p> Results <p>No significant differences were observed between the early and late administration groups in mortality (18.6% vs. 18.4%), need for noninvasive ventilation (32.2% vs. 28.6%), invasive mechanical ventilation (20.6% vs. 20.4%), secondary bacterial infection (20.6% vs. 26.5%), mean days of oxygen support (11.03 vs. 10.57), ICU stay (9.19 vs. 9.36&#xa0;days), or hospital stay (12.66 vs. 12.98&#xa0;days).</p> <p>However, patients who received tocilizumab within 48&#xa0;h had a shorter duration of oxygen support (10.25 vs. 12.49&#xa0;days) and hospital stay (12.25 vs. 14.68&#xa0;days) (<i>p</i> = 0.021 and 0.005, respectively).</p> Conclusion <p>In patients with severe COVID-19 pneumonia, administering tocilizumab within the first 10&#xa0;days of symptom onset did not significantly impact mortality, duration of oxygen support, or length of hospital stay. However, earlier administration (within 48&#xa0;h) was associated with a shorter duration of oxygen support and reduced hospital stay.</p>

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Tocilizumab in severe to critically ill COVID-19 patients: does timing matter?

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月1日

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  • Hany Tawfik Fathelbab,
  • Ahmad Moharam,
  • Khaled Farouk Kotb,
  • Waheed Radwan,
  • Samir Elhadidy Tawfik

摘要

Purpose

Tocilizumab reduces inflammation during cytokine storms, a key driver of acute respiratory distress syndrome (ARDS) in COVID-19. This study evaluates the impact of tocilizumab timing on outcomes in severe to critically ill COVID-19 patients.

Methods

This prospective study included patients with severe to critical COVID-19 pneumonia. Patients were divided into two groups: Group 1 received tocilizumab within 10 days of symptom onset along with standard care, while Group 2 received it after 10 days.

Results

No significant differences were observed between the early and late administration groups in mortality (18.6% vs. 18.4%), need for noninvasive ventilation (32.2% vs. 28.6%), invasive mechanical ventilation (20.6% vs. 20.4%), secondary bacterial infection (20.6% vs. 26.5%), mean days of oxygen support (11.03 vs. 10.57), ICU stay (9.19 vs. 9.36 days), or hospital stay (12.66 vs. 12.98 days).

However, patients who received tocilizumab within 48 h had a shorter duration of oxygen support (10.25 vs. 12.49 days) and hospital stay (12.25 vs. 14.68 days) (p = 0.021 and 0.005, respectively).

Conclusion

In patients with severe COVID-19 pneumonia, administering tocilizumab within the first 10 days of symptom onset did not significantly impact mortality, duration of oxygen support, or length of hospital stay. However, earlier administration (within 48 h) was associated with a shorter duration of oxygen support and reduced hospital stay.