Combination of Tocilizumab and Steroids to Improve Mortality in Patients with Severe COVID-19 Infection: A Spanish, Multicenter, Cohort Study.

We aimed to determine the impact of tocilizumab use on severe COVID-19 (coronavirus disease 19) pneumonia mortality. We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocil...

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Detalles Bibliográficos
Autores: Ruiz-Antorán, Belén, Sancho-López, Aránzazu, Torres, Ferrán, Moreno-Torres, Víctor, de Pablo-López, Itziar, García-López, Paulina, Abad-Santos, Francisco, Rosso-Fernández, Clara M, Aldea-Perona, Ana, Montané, Eva, Aparicio-Hernández, Ruth M, Llop-Rius, Roser, Pedrós, Consuelo, Gijón, Paloma, Hernández-Carballo, Carolina, Pedrosa-Martínez, María J, Rodríguez-Jiménez, Consuelo, Prada-Ramallal, Guillermo, Cabrera-García, Lourdes, Aguilar-García, Josefa A, Sanjuan-Jimenez, Rocío, Ortiz-Barraza, Evelyn I, Sánchez-Chica, Enrique, Fernández-Cruz, Ana, TOCICOV-study group
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/18170
Acceso en línea:http://hdl.handle.net/20.500.12105/18170
Access Level:acceso abierto
Palabra clave:COVID-19
Mortality
SARS-CoV-2
Steroids
Tocilizumab
Descripción
Sumario:We aimed to determine the impact of tocilizumab use on severe COVID-19 (coronavirus disease 19) pneumonia mortality. We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocilizumab were compared to patients not treated with tocilizumab, adjusting by inverse probability of the treatment weights (IPTW). Tocilizumab's effect in patients receiving steroids during the 48 h following inclusion was analysed. During the study period, 506 patients with severe COVID-19 fulfilled the inclusion criteria. Among them, 268 were treated with tocilizumab and 238 patients were not. Median time to tocilizumab treatment from onset of symptoms was 11 days [interquartile range (IQR) 8-14]. Global mortality was 23.7%. Mortality was lower in patients treated with tocilizumab than in controls: 16.8% versus 31.5%, hazard ratio (HR) 0.514 [95% confidence interval (95% CI) 0.355-0.744], p  These results show that survival of patients with severe COVID-19 is higher in those treated with tocilizumab than in those not treated and that tocilizumab's effect adds to that of steroids administered to non-intubated patients with COVID-19 during the first 48 h of presenting with respiratory failure despite oxygen therapy. Randomised controlled studies are needed to confirm these results. European Union electronic Register of Post-Authorization Studies (EU PAS Register) identifier, EUPAS34415.

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