Sarilumab use in severe Coronavirus Disease 2019 pneumonia

Abstract

Background Interleukin-6 (IL-6) signal blockers have an important role in the management of Coronavirus Disease 2019 (COVID-19) and prevent progression of inflammation. Many studies have evaluated the efficacy of Sarilumab in severe COVID-19 pneumonia. Aim Evaluation of sarilumab efficacy in severe COVID-19 pneumonia. Patients and methods In all, 40 patients with severe acute respiratory syndrome coronavirus 2 severe pneumonia received intravenous sarilumab 400 mg. Results Patients were admitted to the ICU with a mean duration of 18.17 ± 8.75 days. Eighteen (45%) patients on high-flow oxygen with nonrebreather masks and 22 (55%) patients on mechanical ventilation received sarilumab. IL-6 level is with a mean of 62.50 ± 23.01 before sarilumab and a mean of 31.35 ± 33.30 after sarilumab. Thirteen (32.5%) patients improved and 27 (67.5%) patients died. No sarilumab serious adverse effects were detected in this study. Patient oxygen saturation on discharge mean was 95.75±.97%. Concerning serum IL-6 levels among the recruited patients, there was statistically significant difference between the mean baseline level compared with the follow-up levels, 62.50 ± 23.01 and 31.35 ± 33.30 ng/ml, respectively, with a P value of 0.001. Conclusion Sarilumab improves IL-6 level in COVID-19 patients with severe pneumonia with no serious adverse effects. Mortality rate increased in severe COVID-19 cases, so early use of sarilumab in moderate cases may decrease disease progression and decrease mortality rate.