Glucocorticoides solos versus tocilizumab solo o glucocorticoides más tocilizumab en pacientes con neumonía grave por SARS-CoV-2 e inflamación moderada / Glucocorticoids alone versus tocilizumab alone or glucocorticoids plus tocilizumab in patients with severe SARS-CoV-2 pneumonia and mild inflammation
Med. clín (Ed. impr.)
; 156(12): 602-605, junio 2021. tab
Article
in Spanish
| IBECS
| ID: ibc-214081
Responsible library:
ES1.1
Localization: ES15.1 - BNCS
RESUMEN
Objetivos:
Analizar si existen diferencias en desenlaces clínicos según el tratamiento inmunosupresor recibido en pacientes con neumonía grave por SARS-CoV-2 e inflamación moderada.MétodosEstudio de cohortes retrospectivo de 142 pacientes con neumonía grave COVID-19 e inflamación moderada. Se dividieron en tres grupos de tratamiento (pulsos de metilprednisolona solo [grupoI], tocilizumab solo [grupoII] y metilprednisolona más tocilizumab [grupoIII]). Analizamos las diferencias intergrupos en el curso clínico con un seguimiento de 60días y factores clínicos analíticos relacionados.ResultadosFallecieron 14 pacientes (9,8%) 8 (10%) del grupoI y 6 (9,5%) de los gruposII yIII. Quince (10,6%) ingresaron en UCI 2 (2,5%) del grupoI, 4 (28,5%) del grupoII y 9 (18,4%) del grupoIII. La estancia media hospitalaria fue mayor en los del grupoII. La evolución clínica no se asoció al tratamiento administrado.ConclusionesEl uso de tocilizumab debería reservarse para escenarios de ensayos clínicos. Su utilización generalizada podría acompañarse de mayor estancia media hospitalaria e ingreso en UCI sin diferencias en la mortalidad con un potencial aumento de efectos adversos. (AU)ABSTRACT
Aim:
To assess clinical outcomes according to the immunosuppressive treatment administered to patients with severe SARS-CoV-2 pneumonia and moderate inflammation.MethodsA retrospective observational cohort study involving 142 patients with severe COVID-19 pneumonia and moderate inflammation divided into three treatment groups (pulses of methylprednisolone alone [groupI], tocilizumab alone [groupII] and methylprednisolone plus tocilizumab [groupIII]). The aim was to assess intergroups differences in the clinical course with a 60-day follow-up and related analytical factors.Results14 patients (9,8%) died 8 (10%) in groupI and 6 (9,5%) in groupsII andIII. 15 (10,6%) were admitted to ICU 2 (2,5%) from groupI, 4 (28,5%) from groupII and 9 (18,4%) from groupIII. The mean hospital stay was longer in groupII and clinical outcome was not associated with treatment.ConclusionsTocilizumab seems to be not associated with better clinical outcomes and should be reserved for clinical trial scenario, since its widespread use may result in higher rate of ICU admission and longer mean hospital stay without differences in mortality rate and potentially adverse events. (AU)
Full text:
Available
Collection:
National databases
/
Spain
Database:
IBECS
Main subject:
Treatment Outcome
/
Coronavirus Infections
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Severe acute respiratory syndrome-related coronavirus
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Antibodies, Monoclonal, Humanized
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Glucocorticoids
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Inflammation
Limits:
Humans
Language:
Spanish
Journal:
Med. clín (Ed. impr.)
Year:
2021
Document type:
Article
Institution/Affiliation country:
Hospital Universitario San Cecilio/España
/
Universidad de Granada/España