The use of prognostic scales to assess the effectiveness of the use of anti-cytokine drugs in patients with moderate and severe course of a new coronavirus infection

Abstract

The aim. To analyze the effectiveness of the use of anti-cytokine drugs (tocilizumab, olokizumab and sarilumab) in a single-center retrospective cohort study based on the prediction of clinical outcomes using prognostic scales, with a single administration in patients with moderate to severe course of a new coronavirus infection.Materials and methods. The retrospective cohort study included three groups of patients with single administration of tocilizumab (65 patients), olokizumab (56 patients) and sarilumab (26 patients). All patients were treated in a repurposed infectious diseases hospital for patients with COVID-19 on the basis of Аlexandro-Mariinskaya Regional Clinical Hospital in the period January- August 2021. Upon admission to the hospital and 2 days after administration of the drug, patients were predicted the severity of the course and outcome using prognostic scales: 4C Mortality Score, COVID-GRAM, SHOCS-COVID.Results. A comparative analysis of the effectiveness of the use of anti-cytokine drugs using the 4C Mortality Score scale revealed a further deterioration in the prognosis of clinical outcome in the groups receiving tocilizumab (p = 0,002) and sarilumab (p = 0,031). When using the COVID-GRAM predictive scale, further deterioration of the prognosis was also noted in the tocilizumab (p = 0,004) and olokizumab (p = 0,005) groups. The SHOCS-COVID scale showed a further deterioration in the prognosis in the tocilizumab group (p = 0,001).Conclusion. The use of drugs based on monoclonal antibodies against IL-6 and its receptors in patients with moderate to severe COVID-19 did not reveal significant positive dynamics in changing the prognosis of clinical outcome 2 days after administration of these drugs.