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Clin Immunol ; 223: 108631, 2021 02.
Article in English | MEDLINE | ID: covidwho-919716

ABSTRACT

Although the starting event in COVID-19 is a viral infection some patients present with an over-exuberant inflammatory response, leading to acute lung injury (ALI) and adult respiratory distress syndrome (ARDS). Since IL-6 plays a critical role in the inflammatory response, we assessed the efficacy and safety of tocilizumab (TCZ) in this single-centre, observational study in all Covid-19 in-patient with a proven SARS-CoV-2 rapidly progressing infection to prevent ALI and ARDS. 104 patients with COVID-19 treated with TCZ had a lower mortality rate (5·8%) compared with the regional mortality rate (11%), hospitalized patient's mortality (10%), and slightly lower than hospitalized patients treated with our standard of care alone (6%). We found that TCZ rapidly decreased acute phase reactants, ferritin and liver release of proteins. D-Dimer decreased slowly. We did not observe specific safety concerns. Early administration of IL6-R antagonists in COVID-19 patients with impending hyperinflammatory response, may be safe and effective treatment to prevent, ICU admission and further complications.


Subject(s)
Acute Lung Injury/drug therapy , Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19/drug therapy , Cytokine Release Syndrome/drug therapy , Inflammation/drug therapy , Respiratory Distress Syndrome/drug therapy , SARS-CoV-2/physiology , Acute Lung Injury/mortality , Aged , COVID-19/mortality , Cohort Studies , Cytokine Release Syndrome/mortality , Female , Ferritins/metabolism , Fibrin Fibrinogen Degradation Products/metabolism , Humans , Inflammation/mortality , Male , Middle Aged , Receptors, Interleukin-6/immunology , Respiratory Distress Syndrome/mortality , Survival Analysis
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