Outcomes of Severe Covid-19 Among Patients Who Did and Did Not Receive Tocilizumab: A Two-year Prospective Cohort Study

Evidence about long-term effects of tocilizumab (TCZ) treatment after COVID-19 is sparse. This study explored COVID-19-related outcomes over a two-year period among people who received TCZ and those who did not. Patients were recruited from two healthcare centers in Serbia, from March 2021 to December 2022. Demographic, clinical, and laboratory data were collected from hospital records. Outcomes of COVID-19 over two years of follow-up, such as post-COVID syndrome (PCS) and mortality, were retrieved from hospital records or through telephone calls. Cumulative two-year mortality in the TCZ cohort (150; 32.8% patients) was 20.6%, and in the non-TCZ cohort (307 patients; 67.2%) 24.7%. In TCZ recipients there was a lower cumulative incidence of PCS (3.4% vs. 9.9%, p = 0.018). Predictors of two-year mortality in both cohorts included age, receiving intensive care unit treatment, having insulin-dependent diabetes, and having elevated C-reactive protein and creatinin kinase on hospital admission. In addition, chest pain on admission, being a smoker, having pre-existing respiratory diseases and cancer along with high aspartate aminotranspherase on admission were predictive of a higher two-year mortality in the non-TCZ cohort. Patients who received TCZ had lower cumulative incidence of PCS and cumulative mortality rates after two years of follow-up. This study suggests that TCZ has potential long-term health benefits for people who were hospitalized for COVID-19.