Journal of Epidemiology and Global Health

In Press, Corrected Proof, Available Online: 7 January 2021

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

Authors
F. Khamis1, *, ORCID, Z. Memish2, ORCID, M. Al Bahrani3, ORCID, H. Al Nummani4, ORCID, D. Al Raisi1, S. Al Dowaiki1, S. Chhetri1, F. Al Fahdi5, ORCID, M. Al Yahyai6, N. Pandak1, ORCID, Z. Al Bolushi1, Z. Alarimi7, ORCID, S. Al Hashmi6, I. Al Salmi8, ORCID, Ibrahim Al-Zakwani9, 10, ORCID
1Department of Infectious Diseases, The Royal Hospital, Ministry of Health, P.O. Box: 1111, A’Seeb, Muscat, Oman
2Director Research & Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Al Faisal University, Riyadh, Kingdom of Saudi Arabia
3Department of Anesthesia and Critical Care, The Royal Hospital, Muscat, Oman
4Department of Pharmacy, The Royal Hospital, Muscat, Oman
5Department of Acute Medicine, The Royal Hospital, Muscat, Oman
6Department of Hematology, The Royal Hospital, Muscat, Oman
7Department of Blood Bank Services, Ministry of Health, Muscat, Oman
8Department of Nephrology, The Royal Hospital, Muscat, Oman
9Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
10Department of Research, Gulf Health Research, Muscat, Oman
*Corresponding author. Email: khami001@gmail.com
Corresponding Author
F. Khamis
Received 16 October 2020, Accepted 11 December 2020, Available Online 7 January 2021.
DOI
https://doi.org/10.2991/jegh.k.201222.001How to use a DOI?
Keywords
COVID-19, convalescent plasma, tocilizumab, mortality, cytokine storm, Oman
Abstract

Aim: As Coronavirus Disease-2019 (COVID-19) pandemic continues to evolve, the search for safe and effective therapeutic interventions remain essential.

Methods: We conducted a retrospective cohort study on patients hospitalized with laboratory confirmed severe acute respiratory syndrome coronavirus-2 infection, comparing standard of care along with Convalescent Plasma with or without Tocilizumab (CP vs. CPT).

Results: A total of 110 patients were enrolled with an overall mean age of 50 ± 16 years. Patients on CPT were more likely to have had acute respiratory distress syndrome (77% vs. 42%; p < 0.001), sepsis (9.7% vs. 0; p = 0.036), chest X-ray abnormalities (71% vs. 44%; p = 0.004), intensive care unit admission (84% vs. 56%; p = 0.001) as well as being on mechanical ventilation (79% vs. 48%; p = 0.001). After CPT treatment, all measured inflammatory markers, except interleukine-6, showed an overall steady decline over time (all p-values <0.05) and the ventilatory parameters showed significant improvement of PaO2/FiO2 ratio from 127 to 188 within 7 days (p < 0.001). Additionally, 52% (32/62) of the patients had favorable outcome, either as improvement of ventilatory parameters or extubation within 14 days of hospitalization. However, mortality rate in those on CPT was higher than those who received CP alone (24% vs. 8.3%; p = 0.041).

Conclusion: In patients with severe COVID-19 infection, using tocilizumab with convalescent plasma is associated with improvement in inflammatory and ventilatory parameters but no effect on mortality. These findings require validation from randomized clinical trials.

Copyright
© 2020 The Authors. Published by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal
Journal of Epidemiology and Global Health
Publication Date
2021/01
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
https://doi.org/10.2991/jegh.k.201222.001How to use a DOI?
Copyright
© 2020 The Authors. Published by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

TY  - JOUR
AU  - F. Khamis
AU  - Z. Memish
AU  - M. Al Bahrani
AU  - H. Al Nummani
AU  - D. Al Raisi
AU  - S. Al Dowaiki
AU  - S. Chhetri
AU  - F. Al Fahdi
AU  - M. Al Yahyai
AU  - N. Pandak
AU  - Z. Al Bolushi
AU  - Z. Alarimi
AU  - S. Al Hashmi
AU  - I. Al Salmi
AU  - Ibrahim Al-Zakwani
PY  - 2021
DA  - 2021/01
TI  - 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
JO  - Journal of Epidemiology and Global Health
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.201222.001
DO  - https://doi.org/10.2991/jegh.k.201222.001
ID  - Khamis2021
ER  -