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Tocilizumab or glucocorticoids treatment for patients with SARS-CoV-2 pneumonia: An observational study.
Dolci, Giovanni; Cassone, Giulia; Besutti, Giulia; Corsini, Romina; Sampaolesi, Fabio; Iotti, Valentina; Galli, Elena; Palermo, Adalgisa; Fontana, Matteo; Mancuso, Pamela.
  • Dolci G; Infectious Disease Unit, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: giodolci@hotmail.it.
  • Cassone G; Rheumatology Unit, IRCCS Arcispedale Santa Maria Nuova, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
  • Besutti G; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Radiology Unit, Department of Imaging and Laboratory Medicine, Azienda USL-IRCCS di Reggio Emilia, Italy.
  • Corsini R; Infectious Disease Unit, Azienda USL-IRCCS di Reggio Emilia, Italy.
  • Sampaolesi F; Infectious Disease Unit, Azienda USL-IRCCS di Reggio Emilia, Italy.
  • Iotti V; Radiology Unit, Department of Imaging and Laboratory Medicine, Azienda USL-IRCCS di Reggio Emilia, Italy.
  • Galli E; Rheumatology Unit, IRCCS Arcispedale Santa Maria Nuova, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
  • Palermo A; Rheumatology Unit, IRCCS Arcispedale Santa Maria Nuova, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
  • Fontana M; Pneumology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
  • Mancuso P; Servizio di epidemiologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy.
Braz J Infect Dis ; 26(1): 101702, 2022.
Article in English | MEDLINE | ID: covidwho-1588201
ABSTRACT

OBJECTIVE:

To estimate the effect of tocilizumab or glucocorticoids in preventing death and intubation in patients hospitalized with SARS-CoV-2 pneumonia.

METHODS:

This was a retrospective cohort study enrolling all consecutive patients hospitalized at Reggio Emilia AUSL between February the 11th and April 14th 2020 for severe COVID-19 and treated with tocilizumab or glucocorticoids (at least 80 mg/day of methylprednisolone or equivalent for at least 3 days). The primary outcome was death within 30 days from the start of the considered therapies. The secondary outcome was a composite outcome of death and/or intubation. All patients have been followed-up until May 19th 2020, with a follow-up of at least 30 days for every patient. To reduce confounding due to potential non-comparability of the two groups, those receiving tocilizumab and those receiving glucocorticoids, a propensity score was calculated as the inverse probability weighting of receiving treatment conditional on the baseline covariates. RESULTS AND

CONCLUSION:

Therapy with tocilizumab alone was associated with a reduction of deaths (OR 0.49, 95% CI 0.21-1.17) and of the composite outcome death/intubation (OR 0.35, 95% CI 0.13-0.90) compared to glucocorticoids alone. Nevertheless, this result should be cautiously interpreted due to a potential prescription bias.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment / Glucocorticoids Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Braz J Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment / Glucocorticoids Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Braz J Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article