الفهرس 
CHARACTERISTICS AND EPIDEMIOLOGY OF COVID-19Only 14 pages are availabe for public view
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Abstract
COVID 19 virus is a member of a family of viruses that can cause diseases similar in characteristics to common cold, severe acute respiratory syndrome also known as SARS, and Middle East respiratory syndrome (MERS). The unprecedented virus was initially detected in China before rapidly causing a global outbreak.
On February 11, 2020, the WHO formally named the illness caused by 2019nCoV as coronavirus disease 2019 (COVID19). The World Health Organization declared COVID 19 a pandemic on March 11, 2020. Coronavirus-2, which causes severe acute respiratory syndrome. There’s evidence that the mode of transmission is human-to-human. It has been proven that COVID 19 spreads primarily through intimate contact and droplet.
The commonest presenting symptoms of coronavirus infection are dyspnea, fever, and cough. Also, there is a correlation between age and the severity of coronavirus infection.
The aim of the current study was to assess the efficiency of tocilizumab in managing coronavirus pneumonia through understanding it’s outcome on 60 patients above the age of 60 years who were enrolled in the intensive care unit at Ain Shams Geriatrics Hospital from 1st of June, 2020 to 31st of August, 2020. Data were gathered retrospectively from medical records guaranteeing patients’ anonymity and confidentiality.
Patients were classified into 2 groups: 30 patients who received the standard of care treatment and tocilizumab (8mg/kg/dose) as a single dose and when clinical improvement does not occur, another dose was given >8hours following the initial dose and the other group consisting of 30 patients who received standard of care treatment only as recommended by WHO guidelines on treatment of COVID 19 2020, CDC recommendations of 2020, and Ain Shams University Guidelines 2020.
It was noted that tocilizumab may be able to reduce the hyperinflammatory reaction connected to the progressive respiratory failure brought on by SARS-CoV-2 by inhibiting the interleukin-6- receptor (IL-6R), one of the main cytokines involved in infection-induced cytokine storm.
It was established that dyspnea was the most prevalent presenting symptom in severe cases with coronavirus pneumonia which was proven to improve after treatment with tocilizumab rather than the standard of care treatment only. Also, Tocilizumab was linked to a dramatic fall in inflammatory biomarkers such as ferritin, LDH, and ALT.
Our study showed that tocilizumab had a significant impact on decreasing oxygen demand and need for mechanical ventilatory mode in elderly cases known to have severe coronavirus pneumonia, while it proved that no similar significance on length of hospital stay and mortality was found, we think that tocilizumab did not affect mortality in our patient despite of decreasing oxygen demand and need of mechanical ventilation as most of our patients had long ICU stay (average three weeks) during which they were exposed to the complications of prolonged ICU stay like secondary bacterial infections, pressure ulcers, and metabolic derangement, all these factors make them complicated cases with poor prognosis regardless of COVID 19 state and its impact.