Abstract: PO0154
Outcomes Associated with Tocilizumab Use in Patients with COVID-19 Infection Complicated by Severe AKI Requiring Continuous Renal Replacement Therapy
Session Information
- COVID-19: Vaccines, Diagnosis, and Treatment
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Ghosn, Muriel, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Attallah, Nizar M., Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Hijazi, Fadi A., Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Madhyastha, Rakesh, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Gupta, Sudeendra S., Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- El Nekidy, Wasim, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
Background
The percentage of critically ill amongst COVID-19 infected patients stands at 5%. The incidence of acute kidney injury in those patients varies according to risk factors. A little is known about the use of Tocilizumab in patients with severe acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT)
Methods
This is a retrospective study of 22 COVID-19 patients. Patients were between 18 and 80 years old, had proven COVID-19 infection, were admitted to the ICU between April 1 and July 15, 2020, received CRRT and Tocilizumab parenterally.
Other therapies included antivirals, hydroxychloroqine and convalescent plasma.
We reported biochemical outcomes related to cytokine storm as well as clinical outcomes; Those included ventilator dependence, renal outcomes, length of hospital stay and mortality
Results
21 out of 22 patients were males. Median age was 56 years. 14 patients had hypertension and 13 had diabetes mellitus. All patients had cytokine storm on admission (elevated IL-6 and CRP levels).
At the completion of the follow up (average 44.4 days), 20 out of 22 patients experienced improvement in IL-6 and CRP levels. 11 patients died. 13 experienced improvement in oxygen requirements including 9 who were succesfully extubated. 13 were still on CRRT (including 10 patients who died) while 9 patients became dialysis independent (5 had complete recovery of kidney function and 4 developed chronic kidney disease).
There was no reported side effect from using tocilizumab
Conclusion
Tocilizumab can be considered in critically ill COVID-19 patients with severe AKI and cytokine storm. No dose adjustment is needed in patients on CRRT. Further studies are required to confirm our results.