Assessment of therapeutic response of the Tocilizumab in SARS-CoV-2 associated cytokine storm: A single center experience

Sat, 23 Apr 2022 00:00:00 +0600

Background: Critical COVID-19 patients may present with a cytokine storm-like phenomenon. IL-6 is found to be a key player in this cytokine storm, and COVID-19 severity is directly linked to the IL-6 levels.

Objective: To assess the response of Tocilizumab during the inflammatory phase of COVID-19 patients.

Methodology: This cross-sectional study was based on a retrospective collection of data from the records of a total of 17 COVID patients, admitted to the COVID Unit of Farooq Hospital, Lahore, from 1^st October 2020 to 30^th December 2020. The ethical review board of Akhtar Saeed Medical and Dental College, Lahore approved the research. All these patients received 8mg/kg of body weight Tocilizumab intravenously for pneumonia in COVID-19 patients. All these patients were evaluated for IL-6 levels in serum initially for 2-3 days (24-48 hours) before and after the 3^rd day and 7^th day of Tocilizumab infusion. The Electrochemiluminescence immunoassay method was used to quantify serum IL-6. The SPSS (v. 22.0) was used for analysis.

Results: The analysis shows that the median (IQR) IL-6 levels prior to treatment with Actemra, three days after Actemra administration, and seven days after Actemra was administered, were 1879 (IQR=726-2842), 1136 (IQR=499-2266), and 438 (IQR=151-1085), respectively. The change in Il-6 levels before and after Actemra administration was statistically significant, (p=0.001). A notable difference was also observed between IL-6 levels with respect to Actemra administration after three and seven days (p=0.04). There was a statistically significant median difference in IL-6 levels seven days post-Actemra in patients who survived and died, (P=0.01).

Conclusion: Tocilizumab administration along with sequential laboratory investigations particularly IL6 might be helpful in reducing the complications of cytokine storm in patients with severe COVID-19 pneumonia, resulting in better outcomes.

Awareness of the mothers about Expanded Programme on Immunization and relation of immunization coverage with maternal education and Covid-19 Pandemic Lockdown

Shahzadi Asma Tahsin — Fri, 10 Jun 2022 00:00:00 +0600

Introduction:Expanded programme of immunization prevents childhood fatal illnesses, and better coverage will raise the herd immunity. Role of mothers is integral in EPI programmes and educated mothers have far better EPI awareness than illiterate or less educated mothers.Objective: To evaluate the relation between the knowledge of mothers about EPI vaccinations and their infant's coverage. Effect of Covid 19 pandemic and lockdown on scheduled immunization.Settings: Paediatric outpatient department and EPI centre, Sadiq Abbasi Hospital Bahawalpur from 01-09-2021 to 15-11-2012. Material and Methods:The mothers were interviewed by the researchers using a structured questionary. Results:There were 200 mothers included in this study. Their mean age ± SD was 29.04 ±7.46 years.Among the studied mothers 20% were having more than 12 years of education. There were 90% mothers who were housewives, 10% were working women. Only 3% women answered correctly about the exact number of EPI vaccines. The awareness about the individual vaccine was 28% to 33%, except in polio vaccine it was 95%, and in measles it was 75%. The 50% mothers answered that EPI vaccines are safe, and 50% believe that they are effective as well. The mother’s high education was associated with better awareness and EPI coverage. Working women and mothers with higher education status were vaccinatedthemselves against covid 19and vaccinated their children also according to EPI schedule.Conclusion:There is lack of knowledge among mothers regarding EPI program, and over the years it is not improving. The educated mothers have been vaccinated themselvesagainst Covid and they have also completed immunization of their children according to EPI schedule.

Journal of Sheikh Zayed Medical College (JSZMC)

Assessment of therapeutic response of the Tocilizumab in SARS-CoV-2 associated cytokine storm: A single center experience

Awareness of the mothers about Expanded Programme on Immunization and relation of immunization coverage with maternal education and Covid-19 Pandemic Lockdown