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J Med Virol . Association Between Inflammatory Markers, Comorbidities, and Mortality in COVID-19 Patients Treated With Tocilizumab

tetano

Editor, Senior Moderator
J Med Virol


. 2026 Jun;98(6):e71028.
doi: 10.1002/jmv.71028.
Association Between Inflammatory Markers, Comorbidities, and Mortality in COVID-19 Patients Treated With Tocilizumab

Rafaela Munari da Silva[SUP] 1 2 [/SUP], Mauricio Santiago Soper[SUP] 1 2 3 [/SUP], Juliana Haider Neves[SUP] 1 2 [/SUP], Carlos Emanuel Antunes Maciel[SUP] 2 [/SUP], Matheus Eduardo de Melo[SUP] 2 [/SUP], Arthur Pille[SUP] 1 3 [/SUP], Juçara Gasparetto Maccari[SUP] 1 3 [/SUP], Mohamed Parrini Mutlaq[SUP] 4 [/SUP], Luiz Antônio Nasi[SUP] 1 5 [/SUP], Jonas Michel Wolf[SUP] 1 2 6 7 [/SUP]


Affiliations
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 d-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.

Keywords: COVID‐19; corticosteroids; prognosis; therapeutic; tocilizumab.

 
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