Effect of tocilizumab treatment for COVID-19-induced acute respiratory distress syndrome (ARDS) on renal function of patients

Purpose: To study the effect of tocilizumab (TCZ) on the renal function of patients with severe coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). Methods: The renal functions of patients with severe COVID-19 were determined before and after TCZ administration using the Cockcroft-Gault method, and the results were compared. The patients who were without kidney failure before COVID-19 infection, were given TCZ for treatment of ARDS. Results: Ninety-two patients (mean age = 62.79 +/- 12.43 y) comprised of 60 men (65.2 %) and 32 women (34.8 %) were included in the study. Mean values and ranges of glomerular filtration rate (GFR) were 92 (59 - 124.25) before TCZ, 102 (65.25 - 121.75) 5 days after TCZ, and 85.5 (64.25 - 134.25) ml/min/1.73 m(2) at 10 days after TCZ (p = 0.670). Similar to GFR, there were no significant differences in the values of blood urea nitrogen (BUN) or creatinine before and after treatment. Moreover, TCZ had no effect on the GFR of 26 patients with stage 3 or above kidney failure associated with COVID-19 (p = 0.540). However, moderate TCZ-related side-effects were observed in 11 patients (11.9 %), while mortality due to COVID-19 occurred in 32 patients (34.8 %). Conclusion: The TCZ used in the treatment of COVID-19-related ARDS did not exert any ameliorating or exacerbating effect on the renal function of patients.