The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort study

Aljuhani, Ohoud, Al Sulaiman, Khalid, B Korayem, Ghazwa, Alharbi, Aisha, Altebainawi, Ali F., Aldkheel, Shatha A., Alotaibi, Sarah G., Vishwakarma, Ramesh, Alshareef, Hanan, Alsohimi, Samiah, AlFaifi, Mashael, Al Shaya, Abdulrahman, Alhaidal, Haifa A., Alsubaie, Raghad M., Alrashidi, Hessah, Albarqi, Khalid J., Alangari, Dalal T., Alanazi, Reem M., Altaher, Noora M. and Al-Dorzi, Hasan M. (2023) The use of Tocilizumab in COVID-19 critically ill patients with renal impairment: a multicenter, cohort study. Renal Failure, 45 (2). pp. 1-10. ISSN 0886-022X

Microsoft Word (rba11-The_use_of_Tocilizumab_in) - Published Version Available under License Creative Commons Attribution Non-commercial. Download (409kB)

Abstract

Tocilizumab (TCZ) is recommended in patients with COVID-19 who require oxygen therapy or ventilatory support. Despite the wide use of TCZ, little is known about its safety and effectiveness in patients with COVID-19 and renal impairment. Therefore, this study evaluated the safety and effectiveness of TCZ in critically ill patients with COVID-19 and renal impairment. A multicenter retrospective cohort study included all adult COVID-19 patients with renal impairment (eGFR˂60 mL/min) admitted to the ICUs between March 2020 and July 2021. Patients were categorized into two groups based on TCZ use (Control vs. TCZ). The primary endpoint was the development of acute kidney injury (AKI) during ICU stay. We screened 1599 patients for eligibility; 394 patients were eligible, and 225 patients were included after PS matching (1:2 ratio); there were 75 TCZ-treated subjects and 150 controls. The rate of AKI was higher in the TCZ group compared with the control group (72.2% versus 57.4%; p = 0.03; OR: 1.83; 95% CI: 1.01, 3.34; p = 0.04). Additionally, the ICU length of stay was significantly longer in patients who received TCZ (17.5 days versus 12.5 days; p = 0.006, Beta coefficient: 0.30 days, 95% CI: 0.09, 0.50; p = 0.005). On the other hand, the 30-day and in-hospital mortality were lower in patients who received TCZ compared to the control group (HR: 0.45, 95% CI: 0.27, 0.73; p = 0.01 and HR: 0.63, 95% CI: 0.41, 0.96; p = 0.03, respectively). The use of TCZ in this population was associated with a statistically significantly higher rate of AKI while improving the overall survival on the other hand. Further research is needed to assess the risks and benefits of TCZ treatment in critically ill COVID-19 patients with renal impairment.

Item Type:	Article
Additional Information:	The authors thank the investigators who participated in this project from the Saudi critical care pharmacy research (SCAPE) platform. The datasets used and/or analyzed during the current study are available from corresponding author on reasonable request.
Uncontrolled Keywords:	acute kidney injury,covid-19,critically ill,renal impairment,tocilizumab,critical care and intensive care medicine,nephrology ,/dk/atira/pure/subjectarea/asjc/2700/2706
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Public Health Faculty of Medicine and Health Sciences > Research Centres > Population Health (former - to 2025)
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	14 Apr 2026 09:34
Last Modified:	14 Apr 2026 09:34
URI:	https://ueaeprints.uea.ac.uk/id/eprint/102769
DOI:	10.1080/0886022X.2023.2268213

Downloads

Actions (login required)

View Item