Tocilizumab for the treatment of adult patients with severe COVID-19 pneumonia: A single-center cohort study.

Abstract:

:Coronavirus disease 2019 (COVID-19) can lead to a massive cytokine release. The use of the anti-interleukin-6 receptor monoclonal antibody tocilizumab (TCZ) has been proposed in this hyperinflammatory phase, although supporting evidence is limited. We retrospectively analyzed 88 consecutive patients with COVID-19 pneumonia that received at least one dose of intravenous TCZ in our institution between 16 and 27 March 2020. Clinical status from day 0 (first TCZ dose) through day 14 was assessed by a 6-point ordinal scale. The primary outcome was clinical improvement (hospital discharge and/or a decrease of ≥2 points on the 6-point scale) by day 7. Secondary outcomes included clinical improvement by day 14 and dynamics of vital signs and laboratory values. Rates of clinical improvement by days 7 and 14 were 44.3% (39/88) and 73.9% (65/88). Previous or concomitant receipt of subcutaneous interferon-β (adjusted odds ratio [aOR]: 0.23; 95% confidence interval [CI]: 0.06-0.94; P = .041) and serum lactate dehydrogenase more than 450 U/L at day 0 (aOR: 0.25; 95% CI: 0.06-0.99; P = .048) were negatively associated with clinical improvement by day 7. All-cause mortality was 6.8% (6/88). Body temperature and respiratory and cardiac rates significantly decreased by day 1 compared to day 0. Lymphocyte count and pulse oximetry oxygen saturation/FiO2 ratio increased by days 3 and 5, whereas C-reactive protein levels dropped by day 2. There were no TCZ-attributable adverse events. In this observational single-center study, TCZ appeared to be useful and safe as immunomodulatory therapy for severe COVID-19 pneumonia.

journal_name

J Med Virol

authors

Fernández-Ruiz M,López-Medrano F,Pérez-Jacoiste Asín MA,Maestro de la Calle G,Bueno H,Caro-Teller JM,Catalán M,de la Calle C,García-García R,Gómez C,Laguna-Goya R,Lizasoáin M,Martínez-López J,Origüen J,Pablos JL,Ripoll M,

doi

10.1002/jmv.26308

subject

Has Abstract

pub_date

2021-02-01 00:00:00

pages

831-842

issue

2

eissn

0146-6615

issn

1096-9071

journal_volume

93

pub_type

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