Tocilizumab use in COVID-19-associated pneumonia.
J Med Virol
; 93(2): 1023-1028, 2021 02.
Article
in English
| MEDLINE | ID: covidwho-1196468
ABSTRACT
BACKGROUND:
We sought to evaluate the effect of tocilizumab (TCB), a recombinant humanized monoclonal antibody against soluble interleukin-6 receptors, in patients hospitalized for coronavirus disease 2019 (COVID-19).METHODS:
We included all patients with laboratory-confirmed COVID-19 who had completed hospitalization between March 10, 2020 and April 10, 2020 with follow-up through April 20, 2020. Patients who received TCB in addition to standard of care within 48 h of admission were matched in a 12 fashion to a similar cohort who received standard of care alone. Clinical outcomes were compared between matched groups. The primary outcome was de-escalation in oxygen therapy. Secondary outcomes were in-hospital death, septic shock, and acute kidney injury (AKI) requiring hemodialysis.RESULTS:
Out of 77 patients who received TCB in addition to standard of care, 34% (n = 26) received TCB within 48 h of admission. One-to-two propensity matching identified 20 versus 40 patients in the TCB and no-TCB treatment arms. In the TCB group, an improvement in oxygenation was observed in 80% (n = 16) of the patients by 7 days post TCB administration. After matching, there was no difference in clinical outcomes between TCB and no-TCB patients. In-hospital death 10% versus 8%; p = .823, septic shock 10% versus 11%, p = .912, AKI requiring hemodialysis (10% vs. 13%; p = .734).CONCLUSIONS:
Early treatment with TCB in patients admitted for COVID-19 led to an improvement in their oxygen status during hospitalization. This change however did not translate into improved survival when compared to a matched cohort with a similar clinical profile.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Antibodies, Monoclonal, Humanized
/
COVID-19
/
Hospitalization
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
J Med Virol
Year:
2021
Document Type:
Article
Affiliation country:
Jmv.26471
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