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Real World Long-term Assessment of The Efficacy of Tocilizumab in Patients with COVID-19: Results From A Large De-identified Multicenter Electronic Health Record Dataset in the United States.
Nigo, Masayuki; Rasmy, Laila; May, Sarah B; Rao, Aishwarya; Karimaghaei, Sam; Kannadath, Bijun Sai; De la Hoz, Alejandro; Arias, Cesar A; Li, Liang; Zhi, Degui.
  • Nigo M; Division of Infectious Diseases, UTHealth McGovern Medical School, Houston, Texas, United States; School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States. Electronic address: masayuki.nigo@uth.tmc.edu.
  • Rasmy L; School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States.
  • May SB; School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States.
  • Rao A; UTHealth McGovern Medical School, Houston, Texas, United States.
  • Karimaghaei S; UTHealth McGovern Medical School, Houston, Texas, United States.
  • Kannadath BS; College of Medicine, University of Arizona - Phoenix, U.S.
  • De la Hoz A; Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics (CARMiG), UTHealth McGovern Medical School, Houston, Texas, United States.
  • Arias CA; Division of Infectious Diseases, UTHealth McGovern Medical School, Houston, Texas, United States; Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics (CARMiG), UTHealth McGovern Medical School, Houston, Texas, United States; Center for Infectious Diseases,
  • Li L; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States.
  • Zhi D; School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, United States. Electronic address: Degui.Zhi@uth.tmc.edu.
Int J Infect Dis ; 113: 148-154, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1506521
ABSTRACT

BACKGROUND:

Studies have shown conflicting results on the efficacy of tocilizumab (TCZ) for patients with COVID-19, with many confounders of clinical status and limited duration of the observation. Here, we evaluate the real-world long-term efficacy of TCZ in COVID-19 patients.

METHODS:

We conducted a retrospective study of hospitalized adult patients with COVID-19 using a large US-based multicenter COVID-19 database (Cerner Real-World Data; updated in September, 2020). The TCZ group was defined as patients who received at least one dose of the drug. Matching weight (MW) and a propensity score weighting method were used to balance confounding factors.

RESULTS:

A total of 20,399 patients were identified. 1,510 and 18,899 were in the TCZ and control groups, respectively. After MW adjustment, no statistically significant differences in all-cause mortality were found for the TCZ vs. control group (Hazard Ratio [HR]0.76, p=0.06). Survival curves suggested a better trend in short-term observation, driven from a subgroup of patients requiring oxygen masks, BIPAP or CPAP.

CONCLUSION:

We observed a temporal (early) benefit of TCZ, especially in patients on non-invasive high-flow supplemental oxygen. However, the benefit effects faded with longer observation. The long-term benefits and risks of TCZ should be carefully evaluated with follow-up studies.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid / Vaccines Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid / Vaccines Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article