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Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia.

Abstract：

BACKGROUND:Pneumonia with respiratory failure represents the main cause of death in COVID-19, where hyper inflammation plays an important role in lung damage. This study aims to evaluate if tocilizumab, an anti-soluble IL-6 receptor monoclonal antibody, reduces patients' mortality. METHODS:85 consecutive patients admitted to the Montichiari Hospital (Italy) with COVID-19 related pneumonia and respiratory failure, not needing mechanical ventilation, were included if satisfying at least one among: respiratory rate ≥ 30 breaths/min, peripheral capillary oxygen saturation ≤ 93% or PaO2/FiO2<=300 mmHg. Patients admitted before March 13th (n=23) were prescribed the standard therapy (hydroxychloroquine, lopinavir and ritonavir) and were considered controls. On March 13th tocilizumab was available and patients admitted thereafter (n=62) received tocilizumab once within 4 days from admission, plus the standard care. RESULTS:Patients receiving tocilizumab showed significantly greater survival rate as compared to control patients (hazard ratio for death, 0.035; 95% confidence interval [CI], 0.004 to 0.347; p = 0.004), adjusting for baseline clinical characteristics. Two out of 62 patients of the tocilizumab group and 11 out of 23 in the control group died. 92% and 42.1% of the discharged patients in the tocilizumab and control group respectively, recovered. The respiratory function resulted improved in 64.8% of the observations in tocilizumab patients who were still hospitalized, whereas 100% of controls worsened and needed mechanical ventilation. No infections were reported. CONCLUSIONS:Tocilizumab results to have a positive impact if used early during Covid-19 pneumonia with severe respiratory syndrome in terms of increased survival and favorable clinical course.

journal_name

Eur J Intern Med

journal_title

European journal of internal medicine

authors

Capra R,De Rossi N,Mattioli F,Romanelli G,Scarpazza C,Sormani MP,Cossi S

doi

10.1016/j.ejim.2020.05.009

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

31-35

eissn

0953-6205

issn

1879-0828

pii

S0953-6205(20)30194-1

journal_volume

pub_type

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Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia.