Effect of Tocilizumab in Mortality among Patients with Severe and Critical Covid-19 : Experience in a Third-Level Medical Center
BACKGROUND: Trials evaluating safety and efficacy of tocilizumab in coronavirus disease 19 (COVID-19) show contradictory results.
OBJECTIVE: The objective of the study was to evaluate the effect of tocilizumab in hospital mortality among patients with severe COVID-19 in a third-level medical center.
METHODS: This prospective cohort study included patients with severe and critical COVID-19. Primary outcome was death during hospitalization. Secondary outcomes included invasive mechanical ventilation (IMV), days on IMV, ventilator-free days (VFDs), length of hospital stay (LOS), and development of hospitalacquired infections (HAIs). Bivariate, multivariate, and propensity score matching analysis were performed.
RESULTS: During the study period, 99/794 (12%) patients received tocilizumab. Male patients, health care workers, and patients with increased inflammatory markers received tocilizumab more frequently. No difference in hospital mortality was observed between groups (34% vs. 34%, p = 0.98). Tocilizumab was not independently associated with mortality. No significant treatment effects were observed in propensity score analysis. IMV was more frequent (46% vs. 11%, p < 0.01) and LOS was longer (12 vs. 7 days, p < 0.01) in the tocilizumab group, reflecting increased severity. Although HAIs were more frequent in the tocilizumab group (22% vs. 10%, p < 0.01), no difference was seen after adjusting for IMV (38% vs. 40%, p = 0.86).
CONCLUSIONS: In our study, tocilizumab was not associated with decreased hospital mortality among patients with severe COVID-19.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
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| Enthalten in: |
Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion - 74(2022), 1 vom: 03. Jan., Seite 40-50 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Martínez-Guerra, Bernardo A [VerfasserIn] |
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| Links: |
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| Themen: |
Antibodies, Monoclonal, Humanized |
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| Anmerkungen: |
Date Completed 14.02.2022 Date Revised 07.12.2022 published: Electronic Citation Status MEDLINE |
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| doi: |
10.24875/RIC.21000404 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM331598094 |
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| 245 | 1 | 0 | |a Effect of Tocilizumab in Mortality among Patients with Severe and Critical Covid-19 |b Experience in a Third-Level Medical Center |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Trials evaluating safety and efficacy of tocilizumab in coronavirus disease 19 (COVID-19) show contradictory results | ||
| 520 | |a OBJECTIVE: The objective of the study was to evaluate the effect of tocilizumab in hospital mortality among patients with severe COVID-19 in a third-level medical center | ||
| 520 | |a METHODS: This prospective cohort study included patients with severe and critical COVID-19. Primary outcome was death during hospitalization. Secondary outcomes included invasive mechanical ventilation (IMV), days on IMV, ventilator-free days (VFDs), length of hospital stay (LOS), and development of hospitalacquired infections (HAIs). Bivariate, multivariate, and propensity score matching analysis were performed | ||
| 520 | |a RESULTS: During the study period, 99/794 (12%) patients received tocilizumab. Male patients, health care workers, and patients with increased inflammatory markers received tocilizumab more frequently. No difference in hospital mortality was observed between groups (34% vs. 34%, p = 0.98). Tocilizumab was not independently associated with mortality. No significant treatment effects were observed in propensity score analysis. IMV was more frequent (46% vs. 11%, p < 0.01) and LOS was longer (12 vs. 7 days, p < 0.01) in the tocilizumab group, reflecting increased severity. Although HAIs were more frequent in the tocilizumab group (22% vs. 10%, p < 0.01), no difference was seen after adjusting for IMV (38% vs. 40%, p = 0.86) | ||
| 520 | |a CONCLUSIONS: In our study, tocilizumab was not associated with decreased hospital mortality among patients with severe COVID-19 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Tocilizumab | |
| 650 | 4 | |a COVID-19 | |
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| 700 | 1 | |a Rajme-López, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a Ortiz-Brizuela, Edgar |e verfasserin |4 aut | |
| 700 | 1 | |a Aguilar-Salinas, Carlos A |e verfasserin |4 aut | |
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