Effects of Tocilizumab on Inflammation and Iron Metabolism in Critically Ill Patients with COVID-19

Szabó, Róbert; Petrișor, Cristina; Bodolea, Constantin; Dobre, Vlad; Trancă, Sebastian; Clichici, Simona; Szabó, I.; Melinte, Răzvan Marian; Mocan, Teodora

doi:10.3390/pharmaceutics15020646

Cited by 4 publications

(3 citation statements)

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“…Low levels of iron have been reported in Romanian patients early on, accordingly to international data [ 56 , 72 , 88 ]; however, there have been cases of normal values reported [ 54 , 86 , 89 , 90 ], while others have reported high levels of FER, including in children [ 14 , 21 , 23 , 24 , 25 , 26 , 29 , 30 , 31 , 35 , 36 , 41 , 43 , 48 , 62 , 74 , 79 ], with a few rare cases of vertical transmission describing increased FER levels, as observed in Iacob et al’s study [ 64 ].…”

Section: Resultsmentioning

confidence: 99%

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COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Musat,

Sorop,

Sorop

et al. 2023

Life

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COVID-19 has significantly impacted the whole world, and Romania was no exception. Biomarkers play a crucial role in understanding and managing the disease. However, research regarding laboratory analyses for patients with COVID-19 is fairly limited. For detection, PCR testing is still considered the golden standard, while antibodies are still useful for monitoring both patients and their vaccination status. In our country, biomarkers such as CRP, LDH, transaminases, cardiac, and iron markers have been used to assess the status of patients and even predict illness outcome. CRP, IL-6, LDH, FER, fibrinogen, creatinine, and vitamin D levels have been associated with increased severity, risk of ICU admission, and death. Cardiac markers and D-dimers are also good predictors, but their role seems more important in patients with complications. HDL cholesterol and BUN levels were also suggested as potential biomarkers. Hematological issues in SARS-CoV-2 infections include neutrophilia, lymphopenia and their ratio, while PCT, which is a marker of bacterial infections, is better to be used in patients with co- or supra-infections. The current research is a narrative review that focuses on the laboratory results of Romanian COVID-19 patients. The goal of this article is to provide an update on the research on biomarkers and other laboratory tests conducted inside the borders of Romania and identify gaps in this regard. Secondly, options for further research are discussed and encouraged.

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Section: Resultsmentioning

confidence: 99%

“…In the end, it did not prove efficient at predicting the occurrence of death [ 74 ]. However, no changes were observed in the study by Szabo et al when it came to hepcidin and its role in Tocilizumab treatment [ 90 ].…”

Section: Resultsmentioning

confidence: 99%

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Musat,

Sorop,

Sorop

et al. 2023

Life

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“…However, one therapeutic agent may not be sufficient to improve multifarious outcomes in various stages of a disease. For example, iron metabolism, the rate of anemia and sepsis occurrence in critically ill COVID-19 patients did not show differences with or without tocilizumab treatment [154]. Indeed, tocilizumab significantly decreases respiratory support requirements and inflammatory markers in COVID-19 patients, but it only reduces mortality if administered at the early inflammatory stages and in high doses in severely ill patients [155].…”

Section: Future Perspectives: Potential Aims and Experimental Methodsmentioning

confidence: 91%

Developmental Impacts of Epigenetics and Metabolism in COVID-19

Naik,

Patel,

Sen

2024

JDB

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Developmental biology is intricately regulated by epigenetics and metabolism but the mechanisms are not completely understood. The situation becomes even more complicated during diseases where all three phenomena are dysregulated. A salient example is COVID-19, where the death toll exceeded 6.96 million in 4 years, while the virus continues to mutate into different variants and infect people. Early evidence during the pandemic showed that the host’s immune and inflammatory responses to COVID-19 (like the cytokine storm) impacted the host’s metabolism, causing damage to the host’s organs and overall physiology. The involvement of angiotensin-converting enzyme 2 (ACE2), the pivotal host receptor for the SARS-CoV-2 virus, was identified and linked to epigenetic abnormalities along with other contributing factors. Recently, studies have revealed stronger connections between epigenetics and metabolism in COVID-19 that impact development and accelerate aging. Patients manifest systemic toxicity, immune dysfunction and multi-organ failure. Single-cell multiomics and other state-of-the-art high-throughput studies are only just beginning to demonstrate the extent of dysregulation and damage. As epigenetics and metabolism directly impact development, there is a crucial need for research implementing cutting-edge technology, next-generation sequencing, bioinformatics analysis, the identification of biomarkers and clinical trials to help with prevention and therapeutic interventions against similar threats in the future.

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The effect of tocilizumab administration on inflammatory markers in COVID-19 patients

Soliman,

Wageh,

Mohamed

et al. 2024

Egypt J Bronchol

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Background The COVID-19 outbreak was declared a worldwide emergency as a result of its rapid spread. The number of people infected with COVID-19 is increasing rapidly around the world, and pneumonia can develop in COVID-19 cases. The monoclonal antibody tocilizumab blocks the interleukin-6 receptor, which in turn reduces inflammation. Aim of the work The study aims to determine how tocilizumab affects inflammatory markers, laboratory indices, and oxygen therapy. Subjects and methods This retrospective observational study aimed to assess the effect of tocilizumab on inflammatory markers, laboratory parameters, and short-term outcomes in COVID-19 cases. Data was collected from 55 patients with COVID-19 who tested positive for SARS-CoV-2 using PCR. These patients were admitted to Ain Shams University Specialized Hospital—Obour between June 1, 2021, and May 31, 2022. Results After tocilizumab administration, C-reactive protein levels decreased significantly, but there was no statistically significant change in hemoglobin, serum ferritin, or D-dimer levels. Following tocilizumab administration, the leukocyte counts, and platelet count increased significantly. There was a significant correlation between the presence of comorbidities in the studied patients (e.g., heart failure, post-renal transplantation, and hepatitis C virus) and the risk of mortality. The study's final result showed a significant decrease in platelet count in dead patients compared to discharged patients after receiving tocilizumab. Regarding oxygen therapy following tocilizumab administration, the use of face masks and non-rebreather facemasks was high in dead patients, while nasal prong usage was high in discharged patients. After receiving tocilizumab, there was an increase in the mean liters of oxygen required in dead patients compared to discharged patients. Conclusion After administration of tocilizumab in COVID-19 hospitalized patients who have progressing disease, there was highly and significantly decrease in CRP level with no statistically significant alteration in the levels of hemoglobin, serum ferritin, and D-dimer and an increase in TLC and platelets was observed. Following tocilizumab administration, there was a decrease in oxygen demands, an improvement in oxygen therapy and oxygen saturation. Tocilizumab is a recommended therapy option.

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Effects of Tocilizumab on Inflammation and Iron Metabolism in Critically Ill Patients with COVID-19

Cited by 4 publications

References 54 publications

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Developmental Impacts of Epigenetics and Metabolism in COVID-19

The effect of tocilizumab administration on inflammatory markers in COVID-19 patients

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