Treatment with Tocilizumab in Adult Patients with Moderate to Critical COVID‐19 Pneumonia: A Single‐Center Retrospective Study
Objectives: This study aimed to assess if tocilizumab (TCZ) timing is associated with improved survival. Material and methods: Data obtained from adult patients with moderate/severe/critical COVID-19 and treated with TCZ, who were admitted to the Teaching Hospital of Infectious Diseases, Cluj-Napoca, Romania (April 2020-April 2021), were retrospectively analyzed. The database included demographics, clinical data, computed tomography scan results, the kinetics of IL-6, laboratory variables, and the outcome until discharge. Results: A total of 221 patients received dexamethasone, antivirals, anticoagulants, and 1-2 doses of TCZ, 8 mg/kg. In 2021, more patients received high-flow oxigen/non-invasive ventilation compared to those hospitalized in 2020, but demographics, in-hospital mortality, and laboratory data did not differ significantly. In-hospital mortality was associated with age, disease severity, lung damage, intensive care unit (ICU) admission, cardiovascular comorbidities, and IL-6<100 pg/mL at TCZ administration. In multivariate analysis the risk of death was significantly higher in patients with a persistent inflammatory state, adjusted odds ratio (aOR) 16.6 (95% CI 3.07-108.96); lung damage<40%, aOR 11.68 (95% CI 2.05-224.98); and cardiovascular comorbidities<2, aOR 3.65 (95% CI 1.06-12.53). TCZ initiation at ≤3 days after admission showed improved survival, odds ratio (OR)=0.39 (95% CI 0.16-0.9). Severe infections were found in 11 (4.9%) patients. Conclusion: Early initiation of TCZ seems beneficial and safe in patients with moderate to critical COVID-19 pneumonia..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:117 |
|---|---|
| Enthalten in: |
International Journal of Infectious Diseases - 117(2022), Seite 7 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Amanda Radulescu [VerfasserIn] |
|---|
| Links: |
doi.org [kostenfrei] |
|---|
| Themen: |
COVID-19 |
|---|
| doi: |
10.1016/j.ijid.2022.01.048 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
DOAJ007353154 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | DOAJ007353154 | ||
| 003 | DE-627 | ||
| 005 | 20230502142502.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 230225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ijid.2022.01.048 |2 doi | |
| 035 | |a (DE-627)DOAJ007353154 | ||
| 035 | |a (DE-599)DOAJ842e3725f5704eacab148ab7d63c4533 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 050 | 0 | |a RC109-216 | |
| 100 | 0 | |a Amanda Radulescu |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Treatment with Tocilizumab in Adult Patients with Moderate to Critical COVID‐19 Pneumonia: A Single‐Center Retrospective Study |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a Objectives: This study aimed to assess if tocilizumab (TCZ) timing is associated with improved survival. Material and methods: Data obtained from adult patients with moderate/severe/critical COVID-19 and treated with TCZ, who were admitted to the Teaching Hospital of Infectious Diseases, Cluj-Napoca, Romania (April 2020-April 2021), were retrospectively analyzed. The database included demographics, clinical data, computed tomography scan results, the kinetics of IL-6, laboratory variables, and the outcome until discharge. Results: A total of 221 patients received dexamethasone, antivirals, anticoagulants, and 1-2 doses of TCZ, 8 mg/kg. In 2021, more patients received high-flow oxigen/non-invasive ventilation compared to those hospitalized in 2020, but demographics, in-hospital mortality, and laboratory data did not differ significantly. In-hospital mortality was associated with age, disease severity, lung damage, intensive care unit (ICU) admission, cardiovascular comorbidities, and IL-6<100 pg/mL at TCZ administration. In multivariate analysis the risk of death was significantly higher in patients with a persistent inflammatory state, adjusted odds ratio (aOR) 16.6 (95% CI 3.07-108.96); lung damage<40%, aOR 11.68 (95% CI 2.05-224.98); and cardiovascular comorbidities<2, aOR 3.65 (95% CI 1.06-12.53). TCZ initiation at ≤3 days after admission showed improved survival, odds ratio (OR)=0.39 (95% CI 0.16-0.9). Severe infections were found in 11 (4.9%) patients. Conclusion: Early initiation of TCZ seems beneficial and safe in patients with moderate to critical COVID-19 pneumonia. | ||
| 650 | 4 | |a Tocilizumab | |
| 650 | 4 | |a IL-6 receptor blockers | |
| 650 | 4 | |a IL-6 | |
| 650 | 4 | |a COVID-19 | |
| 653 | 0 | |a Infectious and parasitic diseases | |
| 700 | 0 | |a Alexandru Istrate |e verfasserin |4 aut | |
| 700 | 0 | |a Monica Muntean |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i In |t International Journal of Infectious Diseases |d Elsevier, 2015 |g 117(2022), Seite 7 |w (DE-627)DOAJ000043923 |x 18783511 |7 nnns |
| 773 | 1 | 8 | |g volume:117 |g year:2022 |g pages:7 |
| 856 | 4 | 0 | |u https://doi.org/10.1016/j.ijid.2022.01.048 |z kostenfrei |
| 856 | 4 | 0 | |u https://doaj.org/article/842e3725f5704eacab148ab7d63c4533 |z kostenfrei |
| 856 | 4 | 0 | |u http://www.sciencedirect.com/science/article/pii/S120197122200056X |z kostenfrei |
| 856 | 4 | 2 | |u https://doaj.org/toc/1201-9712 |y Journal toc |z kostenfrei |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_DOAJ | ||
| 912 | |a SSG-OLC-PHA | ||
| 951 | |a AR | ||
| 952 | |d 117 |j 2022 |h 7 | ||