Analysis of the factors predicting clinical response to tocilizumab therapy in patients with severe COVID-19.
Int J Infect Dis
; 117: 56-64, 2022 Apr.
Article
in English
| MEDLINE | ID: covidwho-1654570
ABSTRACT
BACKGROUND:
Controversy remains about the efficacy of tocilizumab (TCZ) for the treatment of severe COVID-19. We aimed to analyze the profile of TCZ-respondent patients.METHODS:
We retrospectively analyzed a cohort of patients with severe COVID-19 who received off-label TCZ after recommendation by a local committee and were admitted to the University Hospital "12 de Octubre" until May 2020. The primary end point was a significant clinical improvement (SCI) on day 14 after administration of TCZ. Factors independently related to SCI were analyzed by multivariate logistic regression models.RESULTS:
Of 428 (63.3%) patients treated with TCZ, 271 (63.3%) experienced SCI. After adjustment for factors related to unfavorable outcomes, TCZ administration within the first 48 hours from admission (odds ratio [OR] 1.98, 95% confidence Interval [95% CI] 1.1-3.55; P = 0.02) and ALT levels >100 UI/L at day 0 (OR 3.28; 95% CI 1.3-8.1; P = 0.01) were independently related to SCI. The rate of SCI significantly decreased according to the time of TCZ administration 70.2% in the first 48 hours from admission, 58.5% on days 3-7, and 45.1% after day 7 (P = 0.03 and P = 0.001, respectively).CONCLUSION:
TCZ improves the prognosis of patients with COVID-19 the most if treatment starts within the first 48 hours after admission.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19 Drug Treatment
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Int J Infect Dis
Journal subject:
Communicable Diseases
Year:
2022
Document Type:
Article
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