Methylprednisolone continuous infusion versus tocilizumab in treatment of hospitalized COVID‑19 patients: Retrospective data analysis and comparison of effects

Introduction. Cytokine storm substantially complicates the clinical course of COVID-19 disease and can potentially lead to multiorgan failure. At present, there are two groups of cytokine storm control and treatment methods extensively described in literature: pharmacological approach and extracorporeal techniques. Pharmacological approach is most often either to use the tocilizumab-induced interleukin receptor blockade or to suppress inflammatory mediators’ production with glucocorticosteriods.

Materials and methods. We have performed a retrospective statistical analysis of the clinical course of 58 hospitalized COVID-19 patients treated within the pharmacological approach either with monoclonal antibody + glucocorticosteroids (tocilizumab + dexamethasone) or with methylprednisolone in bolus + continuous infusion mode and compared the clinical effects of these two methods with regard to their ability to control inflammation. Results. By the time of antiviral therapy was discontinued all patients demonstrated statistically significant improvement (by nine parameters in tocilizumab group and 11 parameters in methylprednisolone continuous infusion group). IL-6 decrease was statistically significant in methylprednisolone group only. Total survival upon discharge was 96 % in tocilizumab group and 90 % in methylprednisolone group, though this survival difference was not statistically significant.

Conclusions. Our clinical observations and statistical analysis of the retrospective data suggest that the used techniques (tocilizumab + dexamethasone and methylprednisolone bolus + infusion) were similarly effective in the treatment of hospitalized COVID-19 patients. In the view of the compared methods equal efficiency, the use of methylprednisolone appears to be more economically viable. Further research is needed for a detailed study of the results we here describe.

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