Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia

Introduction Tocilizumab (TCZ) is an interleukin-6 receptor antagonist, which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), which aims to ameliorate the cytokine release syndrome (CRS) induced acute respiratory distress syndrome (ARDS). However, there are no consistent data a...

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Detalles Bibliográficos
Autores: Górgolas Hernández-Mora, Miguel, Cabello Úbeda, Alfonso, Prieto Pérez, Laura, Villar Álvarez, Felipe, Álvarez Álvarez, Beatriz, Rodríguez Nieto, María Jesús, Carrillo Acosta, Irene, Fernández Ormaechea, Itziar, Al-Hayani, Aws Waleed Mohammed, Carballosa, María Pilar, Calpena Martínez, Silvia, Ezzine, Farah, Castellanos González, Marina, Naya Prieto, Alba, López de las Heras, Marta, Rodríguez Guzmán, Marcel José, Cordero Guijarro, Ana, Broncano Lavado, Antonio, Macías Valcayo, Alicia, Martín García, Marta, Bécares Martínez, Javier, Fernández Roblas, Ricardo, Piris Pinilla, Miguel Ángel, Fortes Alen, José Román, Sánchez Pernaute, Olga, Romero Bueno, Fredeswinda Isabel, Heili Frades, Sarah, Peces-Barba Romero, Germán
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universidad Autónoma de Madrid
Repositorio:Biblos-e Archivo. Repositorio Institucional de la UAM
Idioma:inglés
OAI Identifier:oai:repositorio.uam.es:10486/743240
Acceso en línea:https://hdl.handle.net/10486/743240
https://dx.doi.org/10.1016/j.ijid.2020.10.045
Access Level:acceso abierto
Palabra clave:SARS-CoV-2
Covid-19
Tocilizumab
Pneumonia
Treatment
Medicina
Descripción
Sumario:Introduction Tocilizumab (TCZ) is an interleukin-6 receptor antagonist, which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), which aims to ameliorate the cytokine release syndrome (CRS) induced acute respiratory distress syndrome (ARDS). However, there are no consistent data about who might benefit most from it. Methods We administered TCZ on a compassionate-use basis to patients with SSP who were hospitalized (excluding intensive care and intubated cases) and who required oxygen support to have a saturation >93%. The primary endpoint was intubation or death after 24 h of its administration. Patients received at least one dose of 400 mg intravenous TCZ from March 8, 2020 to April 20, 2020. Results A total of 207 patients were studied and 186 analyzed. The mean age was 65 years and 68% were male patients. A coexisting condition was present in 68% of cases. Prognostic factors of death were older age, higher IL-6, d-dimer and high-sensitivity C-reactive protein (HSCRP), lower total lymphocytes, and severe disease that requires additional oxygen support. The primary endpoint (intubation or death) was significantly worst (37% vs 13%, p < 0·001) in those receiving the drug when the oxygen support was high (FiO2 >0.5%). Conclusions TCZ is well tolerated in patients with SSP, but it has a limited effect on the evolution of cases with high oxygen support needs

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