Background and Objectives: Mortality and illness due to COVID-19 have been linked to a condition known as cytokine release syndrome (CRS) that is characterized by excessive production of inflammatory cytokines, particularly interleukin-6 (IL-6). Tocilizumab (TCZ), a recent IL-6 antagonist, has been redeployed as adjunctive treatment for CRS remission in COVID-19 patients. This study aimed to determine the efficacy of Tocilizumab on patients’ survival and the length of stay in hospitalized COVID-19 patients admitted to the intensive care unit. Methods: Between January 2021 and June 2021, a multicenter retrospective cohort study was carried out in six tertiary care hospitals in Egypt’s governorate of Giza. Based on the use of TCZ during ICU stay, eligible patients were divided into two groups (control vs. TCZ). In-hospital mortality was the main outcome. Results: A total of 740 patient data records were included in the analysis, where 630 patients followed the routine COVID-19 protocol, while 110 patients received TCZ, need to different respiratory support after hospitalization, and inflammatory mediators such as C-reactive protein (CRP), ferritin, and Lactate dehydrogenase (LDH) showed a statistically significant difference between the TCZ group and the control group. Regarding the primary outcome (discharged alive or death) and neither the secondary outcome (length of hospital stay), there is no statistically significant difference between patients treated with TCZ and the control group. Conclusions: Our cohort of patients with moderate to severe COVID-19 did not assert a reduction in the risk of mortality or the length of stay (LOS) after TCZ administration.

Background The World Health Organization Surgical Safety Checklist (WHO-SSC) is a global tool designed to enhance teamwork and safety in operating rooms (ORs). Its use remains under-reported in the Eastern Mediterranean Region (EMR). This study aimed to assess WHO-SSC awareness, adoption, satisfaction with its implementation, barriers and its impact on healthcare professionals’ safety attitudes. Methods Using a validated questionnaire, a cross-sectional survey was conducted from 11 March to 18 June 2024, in hospitals across 12 countries in the EMR through face-to-face and online distribution. Healthcare professionals’ safety attitude was assessed using the modified operating-room version of the Safety Attitudes Questionnaire. A multiple logistic regression model was used for data analysis, reporting aOR with 95% CIs. Results The study involved 3861 respondents, comprising 1348 surgeons, 1277 OR nurses and 1236 anaesthesiologists. Overall, 52.5% of respondents reported awareness of the WHO-SSC. Among those aware, adoption was highest in private and teaching hospitals and lowest in charity hospitals, with 56.2% expressing satisfaction with its implementation. Reported ‘always’ adherence to the checklist was 32% in elective surgeries, compared with 19% in emergency surgeries. The main barriers included a lack of training, time constraints, limited awareness and poor team communication. Overall, 61.4% of participants demonstrated a positive safety attitude. Positive attitudes were associated with older age, being from a low-income and middle-income country, and WHO-SSC awareness. Conclusion This study emphasises inadequate awareness and adoption of the WHO-SSC in the EMR. Strengthening training, institutional support and context-specific implementation strategies is essential to enhance surgical safety culture in the region.

Tocilizumab, an interleukin-6 receptor antagonist, has been utilized as a treatment for severe COVID-19 cases due to its anti-inflammatory properties. However, its effectiveness in critically ill patients remains controversial. This retrospective cohort study aimed to evaluate the effectiveness of tocilizumab in reducing mortality and improving clinical outcomes in severe or critically ill COVID-19 patients. Data from 320 patients were reviewed, with 105 meeting the inclusion criteria. Patients were divided into two groups: 72 received the standard COVID-19 treatment protocol, and 33 received tocilizumab. The tocilizumab group had a lower mortality rate (63.6%) compared to the standard protocol group (79.2%), although this difference was not statistically significant (risk difference: 15.6%; 95% CI: –4.3 to 35.5; p = 0.091). The length of hospital stay was significantly longer in the tocilizumab group (median: 11 days, IQR: 7–17) compared to the standard treatment group (median: 7.5 days, IQR: 5–12; 95% CI: 0.014–0.019; p = 0.016). Kaplan–Meier survival analysis demonstrated a statistically significant trend in favor of the tocilizumab group (p = 0.021), despite the non-significant difference in overall mortality rates. These findings suggest that tocilizumab may offer a potential survival advantage in severe COVID-19 patients, although further studies are needed to confirm its effectiveness.