The effect of levilimab on the clinical presentations and changes in inflammatory biomarkers in outpatients with mild to moderate COVID-19

Abstract

Introduction. It is now well known that a proportion of patients with COVID-19 develop a pathological systemic inflammatory response with complications resulting in multiple organ failure. The severity and prognosis of the disease, as well as the effectiveness of the treatment provided should be assessed as early as possible. For this purpose, a number of laboratory markers are used, such as C-reactive protein (CRP), IL-6, fibrinogen, ferritin, and changes in these parameters serve as a basis for the disease prognosis.Aim. To evaluate the effectiveness of levilimab in outpatients with COVID-19 based on the analysis of changes in laboratory markers of blood inflammatory activity.Material and methods. A total of 120 patients with COVID-19 receiving standard therapy (ST) were included in the study. The patients were divided into 2 groups: the treatment group of patients who received 2 injections of levilimab, IL-6 receptor blocker, included 47 men and 29 women (average age 46.7 years); the control group, who only received CT, included 21 men and 23 women (average age 46.3 ± 2 years).Results. The treatment group demonstrated a faster normalization of laboratory markers of inflammatory activity. After 14 days of follow-up, the CRP levels in the treatment group decreased significantly by 18.9 (67%) (p < 0.05), and in the control group by 14.3 (46.9%) (p < 0.05). The IL-6 level significantly decreased in patients of the control group, but did not change in the levilimab group. The changes in fibrinogen levels showed that the group of patients, who received levilimab, had a significant decrease in fibrinogen by 35% from baseline (p < 0.05), in contrast to the control group, in which fibrinogen levels virtually did not change (3.8% decrease) (p < 0.05).Conclusion. Levilimab therapy carried out at onset of coronavirus infection results in a faster normalization of laboratory markers of inflammatory activity and helps prevent the severe course of COVID-19.