The Role of Convalescent Plasma and Tocilizumab in the Management of COVID-19 Infection: A Cohort of 110 Patients from a Tertiary Care Hospital in Oman

Abstract

, a novel coronavirus named Severe Acute Respiratory Syndrome-2 (SARS-CoV-2) causing Coronavirus Disease-2019 (COVID-19) has been spreading rapidly causing significant morbidity and mortality worldwide. The clinical presentation of COVID-19 is highly variable, ranging from asymptomatic to severe pneumonia, Acute Respiratory Distress Syndrome (ARDS) that may progress rapidly to respiratory failure, and even requiring invasive Mechanical Ventilation (MV). To date, 66,252,020 cases and 1,524,768 deaths have been reported globally with a fatality rate around 3.0% [1]. Therefore, identifying risk factors for mortality and developing vaccines and novel therapeutics of severe COVID-19 is extremely important now more than ever as the pandemic is still ongoing despite global efforts. Patients admitted with severe COVID-19 infection in the Intensive Care Units (ICU) tend to have higher levels of inflammatory cytokines, including: Tumor Necrosis Factor a (TNF-a), Interleukins (IL) 2, 6, 7, and 10, Granulocyte-Colony Stimulating Factor (G-CSF), monocyte chemoattractant protein 1, macrophage inflammatory protein 1 alpha, and interferon-γ-inducible protein 10; an aberrant host immune response suggesting a "cytokine storm"

Efficacy and safety of Tocilizumab, plasmapheresis and their combination in severe COVID-19: A randomized clinical trial

“…At present, despite the production of differing vaccines, due to their unavailability to specific populations in the world or the reluctance to be vaccinated by some individuals, there are still cases of severe and life-threatening diseases in ICUs. Recognising the role of the inflammatory and cytokine cascade in causing hypoxemia and multi-organ failure in the patients, using Tocilizumab with the aim of inhibiting interleukin 6 receptors and plasmapheresis with the aim to remove inflammatory factors from the body has been studied [22] , [23] , [24] . The biggest limitation of previous studies has been the retrospective analysis in the design of most studies as well as the few existing RCTs (randomized controlled trial).…”