Lack of Difference in Tocilizumab Efficacy in the Treatment of Severe COVID-19 Caused by Different SARS-CoV-2 Variants

Abstract

Tocilizumab (TOC) is presumed to be an effective and safe treatment for severe COVID-19, but its usefulness has not been yet investigated for different SARS-CoV-2 variants. This study aimed to evaluate the influence of TOC on mortality in patients with severe COVID-19 caused by Delta and non-Delta SARS-CoV-2 variants. In a retrospective analysis, we compared the medical records of 78 and 224 patients with severe COVID-19 due to Delta and non-Delta variants, respectively. A total of 30 patients with Delta and 84 with non-Delta variants were treated with TOC in addition to standard therapy. There were no statistically significant differences in mortality rate when comparing Delta vs. non-Delta patients nor when comparing those treated with TOC vs. not treated with TOC in both variants. Using a logistic regression model, in the examined population as a whole, we found an increased (p < 0.05) risk of death as leukocyte and erythrocyte counts decreased and as procalcitonin increased. Increased procalcitonin was significant for mortality in the Delta group, while decreased IL-6, leukocytes, and platelets and increased fibrinogen and procalcitonin were significant in the non-Delta group. Tocilizumab efficacy in severe COVID-19 does not differ between Delta or non-Delta virus variants. The Delta variant of SARS-CoV-2 does not increase mortality when compared to other virus strains.

Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France

“…Other studies [7,8,10,11,19], including platform trials [5,6], have reported a favorable effect of tocilizumab in alpha, beta or gamma cases; however, the benefit of tocilizumab in patients infected with delta, which is reported to be more virulent [20], or in patients infected with omicron, which is, in contrast, reputed to be less virulent [21], remained disputable. To the best of our knowledge, this study was the first to report the use of tocilizumab in a large cohort of severe COVID-19 patients infected with the delta and omicron VOC, suggesting that, among the patients developing a severe form of the disease, the mortality rates were similar in the omicron and delta cases, as it has been reported with previous VOCs [14]. In the same line, some authors have highlighted that the rate of severe COVID-19 may change depending on the VOC, but, in cases of severe forms, they reported that the cytokine secretion remained stable and independent from the VOC [22].…”

“…Unfortunately, in numerous countries, several factors have limited the use of tocilizumab, such as drug shortages, high cost or late approval (December 2021 in Europe, December 2022 in the USA). Therefore, real-life data on tocilizumab treatment remain scarce, especially in patients infected with delta or omicron VOCs [13][14][15]. Moreover, its use is questionable in omicron cases.…”

Factors Influencing Disease Stability and Response to Tocilizumab Therapy in Severe COVID-19: A Retrospective Cohort Study

“…A recent study showed that TCZ efficacy in severe COVID-19 does not differ between Delta or non-Delta virus variants. The Delta variant also did not increase the mortality risk when compared to other virus strains [ 34 ].…”

Пост-Covid-19-Синдром: Діагностичні Критерії, Механізми Патогенезу Та Імунна Відповідь Слизових Оболонок

“…Вірусні інфекції теж можуть викликати постінфекційні розлади з боку ШКТ. Крім того, на частоту розладів з боку ШКТ, підшлункової залози та гепатобіліарної системи впливають препарати із потенційними побічними ефектами, такі, як антибіотики, противірусні препарати, гідроксихлорохін та біологічні препарати, які часто використовують для лікування пацієнтів, уражених COVID-19 [14].…”

“…Враховуючи постковідні симптоми, було розроблено комплексне лабораторне дослідження, яке дозволить оцінити стан організму після перенесеного COVID-19 та визначити найбільш уражені органи та системи організму. Терапевтичні заходи, вчасно застосовані після отримання результатів аналізів, можуть дозволити зменшення проявів постковідного синдрому та покращити якість життя після COVID-19 [14].…”