AB0654 TOCILIZUMAB IS PROTECTIVE AGAINST SARS-COV2 INFECTION OR NOT?

Abstract

Background: SARS-COV2 (Covid19) pandemic has a scaring burden on hospitals and health care providers all over the world. Unfortunately, after one year of pandemic, millions of persons are infected either mild symptoms or critical ones and unexplained deaths. Till now, No effective treatment or vaccination. Researches showed that Covid 19 associated with elevated interleukin-6. Subsequently, Studies reported that tocilizumab (IL-6 antagonist) may be effective in critical patients even though other were shown that it is not associated with reduction in the mortality.(1,2) Therefore the question is that patients with rheumatic diseases who are already receiving tocilizumab having a primary protection against infection of Covid 19 in comparing to other receiving the other biologicals or conventional Therapy or not. Objectives: Our objective was to determine if tocolizumab had a primary protection against SARS-COV2 in comparing to patients were on other biologics. Methods: A Retrospective study was done among 100 patients with rheumatic diseases (Group 1: 10 on tocilizumab, Group2: 40 (30 on antiTNF and 10 on IL17 antagonist), Group3: on cDMARDs) from March to Dec 2020. Detailed history, clinical presentation, laboratory, computed tomography of chest and PCR for covid 19 if presented among infected patients. Results: Among 100 patients of median age 21, 19 patient (19%) had infected with Covid 19 (2 on tocilizumab, 6 on antiTNF, 1 on IL17 antagonist, 10 on cDMARDs). Symptoms were reported fever (89.4%), Fatigue (78.9%), myalgia (78.9%), Headache (73.7%), Dyspnea (52.6%), Cough (47.3%), chest pain (26.3%) and hypoxia (5%). CT findings were positive in 10 patients (52.63%) while PCR was done and positive in 15 out of 19 (78.94%). Nevertheless, there was no significant statistically difference between groups according to infection with SARS-COV2. (p=0.704) Conclusion: Tocilizumab is not shown to be protective against SARS-COV2 (COVID 19) infection compared to other biological or cDMARDs in patients with rheumatic diseases.