The association between tocilizumab and the secondary bloodstream infection maybe nonsignificant in hospitalized patients with SARS-CoV-2 infection: A cohort study
Background: Immunomodulatory agents, such as tocilizumab (TCZ), exert promising effects against SARS-CoV-2 infection. However, growing evidence indicates that using TCZ may carry higher risks of secondary bloodstream infection (sBSI). This study determined whether TCZ is associated with an increased risk of sBSI. Methods: We retrospectively collected the demographic and clinical data of hospitalized patients with SARS-CoV-2 infection from two Taiwanese hospitals. The time-to-incident sBSI in the TCZ users and nonusers was compared using the log-rank test. A multivariate Cox proportional hazards model was performed to identify independent risk factors for sBSI. Results: Between May 1 and August 31, 2021, among 453 patients enrolled, 12 (2.65 %) developed sBSI. These patients were in hospital for longer duration (44.2 ± 31.4 vs. 17.6 ± 14.3 days, p = 0.014). Despite sBSI being more prevalent among the TCZ users (7.1 % vs. 1.6 %, p = 0.005), Kaplan–Meier survival analysis and multivariate Cox proportional hazards model both revealed no significant difference in risks of sBSI between the TCZ users and nonusers [adjusted HR (aHR) = 1.32 (95 % confidence interval (CI) = 0.29–6.05), p = 0.724]. Female sex [aHR = 7.00 (95 % CI = 1.45–33.92), p = 0.016], heavy drinking [aHR = 5.39 (95 % CI = 1.01–28.89), p = 0.049], and mechanical ventilation [aHR = 5.65 (95 % CI = 1.67–19.30), p = 0.006] were independently associated with a higher sBSI risk. Conclusion: This real-world evidence indicates that in hospitalized patients with SARS-CoV-2 infection, TCZ does not significantly increase the risk of sBSI..
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2024 |
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Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - volume:57 |
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Enthalten in: |
Journal of Microbiology, Immunology and Infection - 57(2024), 1, Seite 38-47 |
Sprache: |
Englisch |
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Beteiligte Personen: |
De-En Lu [VerfasserIn] |
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Links: |
doi.org [kostenfrei] |
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Themen: |
Microbiology |
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doi: |
10.1016/j.jmii.2023.10.011 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
DOAJ094756325 |
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520 | |a Background: Immunomodulatory agents, such as tocilizumab (TCZ), exert promising effects against SARS-CoV-2 infection. However, growing evidence indicates that using TCZ may carry higher risks of secondary bloodstream infection (sBSI). This study determined whether TCZ is associated with an increased risk of sBSI. Methods: We retrospectively collected the demographic and clinical data of hospitalized patients with SARS-CoV-2 infection from two Taiwanese hospitals. The time-to-incident sBSI in the TCZ users and nonusers was compared using the log-rank test. A multivariate Cox proportional hazards model was performed to identify independent risk factors for sBSI. Results: Between May 1 and August 31, 2021, among 453 patients enrolled, 12 (2.65 %) developed sBSI. These patients were in hospital for longer duration (44.2 ± 31.4 vs. 17.6 ± 14.3 days, p = 0.014). Despite sBSI being more prevalent among the TCZ users (7.1 % vs. 1.6 %, p = 0.005), Kaplan–Meier survival analysis and multivariate Cox proportional hazards model both revealed no significant difference in risks of sBSI between the TCZ users and nonusers [adjusted HR (aHR) = 1.32 (95 % confidence interval (CI) = 0.29–6.05), p = 0.724]. Female sex [aHR = 7.00 (95 % CI = 1.45–33.92), p = 0.016], heavy drinking [aHR = 5.39 (95 % CI = 1.01–28.89), p = 0.049], and mechanical ventilation [aHR = 5.65 (95 % CI = 1.67–19.30), p = 0.006] were independently associated with a higher sBSI risk. Conclusion: This real-world evidence indicates that in hospitalized patients with SARS-CoV-2 infection, TCZ does not significantly increase the risk of sBSI. | ||
650 | 4 | |a SARS-CoV-2 infection | |
650 | 4 | |a Secondary bloodstream infections | |
650 | 4 | |a Tocilizumab | |
653 | 0 | |a Microbiology | |
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