Association Between Inflammatory Markers, Comorbidities, and Mortality in COVID‐19 Patients Treated With Tocilizumab

ABSTRACT

Tocilizumab, an interleukin‐6 receptor antagonist, has been widely used in the management of severe COVID‐19 cases, but its clinical outcomes have been variable. A retrospective cohort including 113 hospitalized adult patients with confirmed COVID‐19 treated with tocilizumab between March and October 2021 at a private hospital in southern Brazil. Demographic, clinical, and laboratory variables were collected at four time points: admission, 72 h before tocilizumab administration, 72 h after, and at hospital discharge or death. The median age was significantly higher among non‐survivors (73.0 vs. 58.5 years; p  < 0.01). Cardiovascular, metabolic, pulmonary, and neoplastic comorbidities negatively impacted clinical outcomes. These patients also showed persistent elevation of inflammatory markers and organ dysfunction indicators, such as

‐dimer, urea, and BNP. Concomitant use of corticosteroids was associated with improved survival ( p  = 0.04). Age, comorbidities, and persistent elevation of inflammatory markers were associated with worse prognosis in patients treated with tocilizumab. Concomitant use of corticosteroids demonstrated a potential benefit, suggesting a synergistic effect between the therapies. These findings underscore the importance of laboratory monitoring and individualized therapeutic approaches in severe COVID‐19.