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Tocilizumab reduces the risk of ICU admission and mortality in patients with SARS-CoV-2 infection.
Rev Esp Quimioter ; 34(3): 238-244, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1173137
Semantic information from SemMedBD (by NLM)
1. tocilizumab TREATS COVID-19
Subject
tocilizumab
Predicate
TREATS
Object
COVID-19
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. tocilizumab TREATS Patients
Subject
tocilizumab
Predicate
TREATS
Object
Patients
4. 2019 novel coronavirus CAUSES Immune response
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Immune response
5. Judgment PROCESS_OF Attending physician
Subject
Judgment
Predicate
PROCESS_OF
Object
Attending physician
6. tocilizumab ADMINISTERED_TO Patients
Subject
tocilizumab
Predicate
ADMINISTERED_TO
Object
Patients
7. tocilizumab TREATS COVID-19
Subject
tocilizumab
Predicate
TREATS
Object
COVID-19
8. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
9. tocilizumab TREATS Patients
Subject
tocilizumab
Predicate
TREATS
Object
Patients
10. 2019 novel coronavirus CAUSES Immune response
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Immune response
11. Judgment PROCESS_OF Attending physician
Subject
Judgment
Predicate
PROCESS_OF
Object
Attending physician
12. tocilizumab ADMINISTERED_TO Patients
Subject
tocilizumab
Predicate
ADMINISTERED_TO
Object
Patients
ABSTRACT

OBJECTIVE:

In some patients the immune response triggered by SARS-CoV-2 is unbalanced, presenting an acute respiratory distress syndrome which in many cases requires intensive care unit (ICU) admission. The limitation of ICU beds has been one of the major burdens in the management around the world; therefore, clinical strategies to avoid ICU admission are needed. We aimed to describe the influence of tocilizumab on the need of transfer to ICU or death in non-critically ill patients.

METHODS:

A retrospective study of 171 patients with SARS-CoV-2 infection that did not qualify as requiring transfer to ICU during the first 24h after admission to a conventional ward, were included. The criteria to receive tocilizumab was radiological impairment, oxygen demand or an increasing of inflammatory parameters, however, the ultimate decision was left to the attending physician judgement. The primary outcome was the need of ICU admission or death whichever came first.

RESULTS:

A total of 77 patients received tocilizumab and 94 did not. The tocilizumab group had less ICU admissions (10.3% vs. 27.6%, P=0.005) and need of invasive ventilation (0 vs 13.8%, P=0.001). In the multivariable analysis, tocilizumab remained as a protective variable (OR 0.03, CI 95% 0.007-0.1, P=0.0001) of ICU admission or death.

CONCLUSIONS:

Tocilizumab in early stages of the inflammatory flare could reduce an important number of ICU admissions and mechanical ventilation. The mortality rate of 10.3% among patients receiving tocilizumab appears to be lower than other reports. This is a non-randomized study and the results should be interpreted with caution.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Antibodies, Monoclonal, Humanized / COVID-19 / Hospitalization / Intensive Care Units Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Female / Humans / Male / Middle aged Language: English Journal: Rev Esp Quimioter Journal subject: Drug Therapy Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Antibodies, Monoclonal, Humanized / COVID-19 / Hospitalization / Intensive Care Units Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Female / Humans / Male / Middle aged Language: English Journal: Rev Esp Quimioter Journal subject: Drug Therapy Year: 2021 Document Type: Article