The combination of two immunomodulatory drugs could be beneficial for more severe Covid-19 patients

A total of 44 researchers from the Bellvitge Biomedical Research Institute (IDIBELL) and Bellvitge University Hospital (HUB) sign an article in the International Journal of Infectious Diseases, where they demonstrate the beneficial effect of the use of corticosteroids added to tocilizumab treatment to improve the prognosis of critical patients of Covid-19.

Until now, the obtained results suggest that the severe stages of Covid-19 could be due to a strong immune reaction. For this reason, the use of immunomodulatory drugs, such as tocilizumab or corticosteroids, has been recommended in such patients. Several studies indicate a beneficial effect of tocilizumab, however, so far there has been no evidence that the combination with corticosteroids could be an advantage. Therefore, IDIBELL and Bellvitge University Hospital initiated a retrospective study to evaluate the response of patients treated with tocilizumab alone, or with tocilizumab and corticosteroids.

The interest of the study lies both in its relevant results and in the unusual number of participants, which is a tribute to the important work that IDIBELL and HUB professionals are doing in a transversal way.

The study included 186 Covid-19 patients treated with tocilizumab in March and April – one of the biggest published series – of whom 129 also received corticosteroids. The findings, apart from revealing the beneficial effect of corticosteroids added to tocilizumab in the prognosis of severe patients, also indicate that mortality was associated with old age, chronic heart failure, and liver disease. However, the use of tocilizumab for Covid-19 cases, with or without steroids, is still under discussion.