Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia

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

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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Authors:	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
Format:	article
Publication Date:	2020
Country:	España
Institution:	Universidad Autónoma de Madrid
Repository:	Biblos-e Archivo. Repositorio Institucional de la UAM
Language:	English
OAI Identifier:	oai:repositorio.uam.es:10486/743240
Online Access:	https://hdl.handle.net/10486/743240 https://dx.doi.org/10.1016/j.ijid.2020.10.045
Access Level:	Open access
Keyword:	SARS-CoV-2 Covid-19 Tocilizumab Pneumonia Treatment Medicina

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spelling	Compassionate use of tocilizumab in severe SARS-CoV2 pneumoniaGórgolas Hernández-Mora, MiguelCabello Úbeda, AlfonsoPrieto Pérez, LauraVillar Álvarez, FelipeÁlvarez Álvarez, BeatrizRodríguez Nieto, María JesúsCarrillo Acosta, IreneFernández Ormaechea, ItziarAl-Hayani, Aws Waleed MohammedCarballosa, María PilarCalpena Martínez, SilviaEzzine, FarahCastellanos González, MarinaNaya Prieto, AlbaLópez de las Heras, MartaRodríguez Guzmán, Marcel JoséCordero Guijarro, AnaBroncano Lavado, AntonioMacías Valcayo, AliciaMartín García, MartaBécares Martínez, JavierFernández Roblas, RicardoPiris Pinilla, Miguel ÁngelFortes Alen, José RománSánchez Pernaute, OlgaRomero Bueno, Fredeswinda IsabelHeili Frades, SarahPeces-Barba Romero, GermánSARS-CoV-2Covid-19TocilizumabPneumoniaTreatmentMedicinaIntroduction 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 needsElsevierInternational Society for Infectious DiseasesDepartamento de Anatomía PatológicaDepartamento de MedicinaFacultad de Medicina20202020-10-25research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10486/743240https://dx.doi.org/10.1016/j.ijid.2020.10.04533115682reponame:Biblos-e Archivo. Repositorio Institucional de la UAMinstname:Universidad Autónoma de MadridInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositorio.uam.es:10486/7432402026-06-23T12:46:27Z
dc.title.none.fl_str_mv	Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title	Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
spellingShingle	Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia Górgolas Hernández-Mora, Miguel SARS-CoV-2 Covid-19 Tocilizumab Pneumonia Treatment Medicina
title_short	Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title_full	Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title_fullStr	Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title_full_unstemmed	Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
title_sort	Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
dc.creator.none.fl_str_mv	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
author	Górgolas Hernández-Mora, Miguel
author_facet	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
author_role	author
author2	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
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author author
dc.contributor.none.fl_str_mv	Departamento de Anatomía Patológica Departamento de Medicina Facultad de Medicina
dc.subject.none.fl_str_mv	SARS-CoV-2 Covid-19 Tocilizumab Pneumonia Treatment Medicina
topic	SARS-CoV-2 Covid-19 Tocilizumab Pneumonia Treatment Medicina
description	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
publishDate	2020
dc.date.none.fl_str_mv	2020 2020-10-25
dc.type.none.fl_str_mv	research article http://purl.org/coar/resource_type/c_2df8fbb1 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv	info:eu-repo/semantics/article
format	article
dc.identifier.none.fl_str_mv	https://hdl.handle.net/10486/743240 https://dx.doi.org/10.1016/j.ijid.2020.10.045 33115682
url	https://hdl.handle.net/10486/743240 https://dx.doi.org/10.1016/j.ijid.2020.10.045
identifier_str_mv	33115682
dc.language.none.fl_str_mv	Inglés eng
language_invalid_str_mv	Inglés
language	eng
dc.rights.none.fl_str_mv	open access http://purl.org/coar/access_right/c_abf2 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv	info:eu-repo/semantics/openAccess
rights_invalid_str_mv	open access http://purl.org/coar/access_right/c_abf2 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv	openAccess
dc.format.none.fl_str_mv	application/pdf
dc.publisher.none.fl_str_mv	Elsevier International Society for Infectious Diseases
publisher.none.fl_str_mv	Elsevier International Society for Infectious Diseases
dc.source.none.fl_str_mv	reponame:Biblos-e Archivo. Repositorio Institucional de la UAM instname:Universidad Autónoma de Madrid
instname_str	Universidad Autónoma de Madrid
reponame_str	Biblos-e Archivo. Repositorio Institucional de la UAM
collection	Biblos-e Archivo. Repositorio Institucional de la UAM
repository.name.fl_str_mv
repository.mail.fl_str_mv
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Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia

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