Evidence mapPaperPMID 40657013Full record

ArticleInfectious diseases & clinical microbiology2025

Potential Predictors of the Outcome of Tocilizumab Treatment in Patients with COVID-19-Associated Hyperinflammation.

Shirkhan Amikishiyev, Murat Bektaş, Mehmet Güven Günver, Burak İnce, Sarvan Aghamuradov, Nevzat Koca, Naci Şenkal, Görkem Durak, Murat Köse, Mustafa Erelel and 5 more

Abstract read
In one paragraph

Article in Infectious diseases & clinical microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Shirkhan AmikishiyevDepartment of Internal Medicine, Division of Rheumatology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-8355-0176
Murat BektaşDepartment of Internal Medicine, Division of Rheumatology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-1788-3837
Mehmet Güven GünverDepartment of Medical Statistics, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-4628-8391
Burak İnceDepartment of Internal Medicine, Division of Rheumatology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0001-9813-2228
Sarvan AghamuradovDepartment of Internal Medicine, Division of Rheumatology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-7196-0098
Nevzat KocaDepartment of Internal Medicine, Division of Rheumatology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-4788-7935
Naci ŞenkalDepartment of Internal Medicine, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0001-7072-8724
Görkem DurakDepartment of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-1608-1955
Murat KöseDepartment of Internal Medicine, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0001-9858-6246
Mustafa ErelelDepartment of Chest Diseases, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-8584-8734
Arif Atahan ÇağatayDepartment of Infectious Diseases and Clinical Microbiology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-3051-8199
Serap Şimşek-YavuzDepartment of Infectious Diseases and Clinical Microbiology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-4675-169X
Sevgi Kalayoğlu-BeşışıkDepartment of Internal Medicine, Division of Haematology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0002-9310-1278
Figen EsenDepartment of Anaesthesiology and Reanimation, Intensive Care Unit, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0003-4419-4903
Ahmet GülDepartment of Internal Medicine, Division of Rheumatology, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye.ORCID https://orcid.org/0000-0001-8219-3720

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: During the COVID-19 pandemic, a subset of patients developed COVID-19-associated hyperinflammation (HIC), which resulted in increased mortality. While early and effective anti-inflammatory therapies, such as glucocorticoids and tocilizumab, improved survival, tools to predict treatment response remained lacking. This study aimed to identify predictors of clinical outcomes in patients who received tocilizumab for HIC. Materials and Methods: We retrospectively analyzed the records of hospitalized adult patients with COVID-19 treated between March and December 2020. Patients who received tocilizumab for HIC constituted the study cohort. Dynamic changes in the laboratory parameters were analyzed, and the HIC scores (≥35) were calculated to assess disease severity and treatment response. Results: Out of 961 hospitalized COVID-19 patients, 150 who received tocilizumab were identified. Among them, 124 were treated with only tocilizumab in the first phase of the pandemic (from March to September 2020). After this period, 26 patients also received glucocorticoids, typically initiated 2-3 days prior to tocilizumab administration. Anakinra treatment was given to 22 patients whose inflammatory parameters did not resolve with tocilizumab. Findings of HIC were treated in 122 patients (84%), with a significant reduction in C-reactive protein (CRP) levels (from 121.8 ± 8.2 to 9.8 ± 2.8 mg/L). Despite tocilizumab treatment, no effective resolution of the CRP response was observed (from 172 ± 22.8 to 53 ± 8 mg/L by Day 5) among non-survivors, alongside increasing trends in neutrophil count, D-dimer, lactate dehydrogenase (LDH), troponin, and creatine kinase. The composite HIC scores progressively decreased in survivors until the last day of hospitalization but increased in non-survivors (33.8 ± 0.14 vs. 72.3 ± 0.13). Conclusion: Analysis of this cohort indicated that neutrophil count, CRP, D-dimer, LDH, troponin, and creatine kinase levels may serve as predictors of tocilizumab efficacy on Day 5. The score developed to diagnose HIC can also be used for monitoring treatment response.

Indexed as

COVID-19glucocorticoidsHIC scorehyperinflammationprognosisresponsetocilizumabtreatment

Identifiers

PMID40657013
PMCPMC12255900

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.