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Research Article
Implications of tocilizumab based COVID-19 treatment on liver function tests: A one month retrospective analysis of unprecedented tocilizumab use during the peak of the SARS-CoV-2 pandemic in New York
1 Department of Internal Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA
2 Department of Infectious Disease, Nassau University Medical Center, East Meadow, NY, USA
3 Department of Internal Medicine and Gastroenterology, Nassau University Medical Center, East Meadow, NY, USA
Address correspondence to:
Kristen Farraj
DO, Department of Internal Medicine, 2201 Hempstead Turnpike, East Meadow, NY 11554,
USA
Message to Corresponding Author
Article ID: 100015G01KF2021
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How to cite this article
Farraj K, Sheikh S, Imbrie R, Rammohan R, Ahmed S, Mustacchia P, Kagolanu D. Implications of tocilizumab based COVID-19 treatment on liver function tests: A one month retrospective analysis of unprecedented tocilizumab use during the peak of the SARS-CoV-2 pandemic in New York. Edorium J Gastroenterol 2021;8:100015G01KF2021.ABSTRACT
Aims: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been associated with a spectrum of gastrointestinal (GI) symptoms and elevated liver-related tests (LRTs). It is unclear if GI pathology and liver injury are related to direct SARS-CoV-2 viral effects, drugs used for treatment, a systemic inflammatory response, or a complicated disease course. Our retrospective study aimed to assess the effects of tocilizumab (TCZ) on GI symptoms, LRTs, and coagulation factors in SARS-CoV-2 patients hospitalized during April 2020.
Methods: A retrospective chart review was conducted, evaluating for the prevalence of vomiting, diarrhea, changes in LRTs, and coagulation panels in all SARS-CoV-2 patients admitted during April 2020. The study group included 69 patients who received TCZ and the control group included 73 patients who did not receive TCZ.
Results: Liver function tests (LFTs) increased after TCZ administration when compared to LFTs in the control group. Study group versus control group: aspartate aminotransferase (AST) [75±49.18 vs 63±15.03 p
Conclusion: In our study, TCZ use was associated with an increase in ALT, AST, and INR and a decrease in TB. It is difficult to assess whether this rise in ALT is due to SARS-CoV-2 or a consequence of TCZ itself.
Keywords: COVID-19, Liver, Liver function test, Pneumonia, SARS-CoV-2
SUPPORTING INFORMATION
Author Contributions
Kristen Farraj - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Saher Sheikh - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ross Imbrie - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Rajmohan Rammohan - Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Shadab Ahmed - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Paul Mustacchia - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Deepthi Kagolanu - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementConsent was unable to be obtained as it is a retrospective study conducted during a pandemic and most of the patients in this study unfortunately expired. IRB approval was obtained and an exception was given in regard to consent due to the situation at the time.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Kristen Farraj et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
