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Early Tocilizumab Dosing Is Associated With Improved Survival in Critically Ill Patients Infected With Severe Acute Respiratory Syndrome Coronavirus-2.
Petrak, Russell M; Van Hise, Nicholas W; Skorodin, Nathan C; Fliegelman, Robert M; Chundi, Vishnu; Didwania, Vishal; Han, Alice; Harting, Brian P; Hines, David W.
  • Petrak RM; All authors: Metro Infectious Disease Consultants, Burr Ridge, IL.
  • Van Hise NW; All authors: Metro Infectious Disease Consultants, Burr Ridge, IL.
  • Skorodin NC; All authors: Metro Infectious Disease Consultants, Burr Ridge, IL.
  • Fliegelman RM; All authors: Metro Infectious Disease Consultants, Burr Ridge, IL.
  • Chundi V; All authors: Metro Infectious Disease Consultants, Burr Ridge, IL.
  • Didwania V; All authors: Metro Infectious Disease Consultants, Burr Ridge, IL.
  • Han A; All authors: Metro Infectious Disease Consultants, Burr Ridge, IL.
  • Harting BP; All authors: Metro Infectious Disease Consultants, Burr Ridge, IL.
  • Hines DW; All authors: Metro Infectious Disease Consultants, Burr Ridge, IL.
Crit Care Explor ; 3(4): e0395, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1168636
ABSTRACT
To identify the most efficacious timing for tocilizumab administration in critically ill patients infected with severe acute respiratory syndrome coronavirus-2.

DESIGN:

Observational multicenter cohort study.

SETTING:

A total of 23 acute care hospitals in four states. PATIENTS One-hundred eighteen patients admitted between March 13, 2020, and April 16, 2020. Eighty-one patients received tocilizumab, and 37 were untreated and served as a control group. MEASUREMENTS AND MAIN

RESULTS:

The main outcome was mortality and was analyzed by timing of tocilizumab dosing. Early dosing was defined as a tocilizumab dose administered prior to or within 1 day of intubation. Late dosing was defined as a dose administered greater than 1 day after intubation. A control group that was treated only with standard of care, and without tocilizumab, was used for comparison. Early tocilizumab therapy was associated with a statistically significant decrease in mortality as compared to patients who were untreated (p = 0.003). Dosing tocilizumab late was associated with an increased mortality compared with the untreated group (p = 0.006).

CONCLUSIONS:

Early tocilizumab administration was associated with decreased mortality in critically ill severe acute respiratory syndrome coronavirus-2 patients, but a potential detriment was suggested by dosing later in a patient's course.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Crit Care Explor Year: 2021 Document Type: Article Affiliation country: CCE.0000000000000395

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Crit Care Explor Year: 2021 Document Type: Article Affiliation country: CCE.0000000000000395