Early outcomes adults hospitalized with severe COVID-19 receiving tocilizumab

Background: Modulation of the immune system to prevent lung injury is being widely used against the new coronavirus disease (COVID-19) despite the scarcity of evidence. Methods: We report the preliminary results from the Vall d'Hebron prospective cohort study at Vall d'Hebron University Ho...

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Detalles Bibliográficos
Autores: Sánchez Montalvá, Adrián|||0000-0002-2194-5447, Sellarès-Nadal, Júlia|||0000-0002-0209-6494, Espinosa-Pereiro, Juan|||0000-0002-7238-8337, Fernández-Hidalgo, Nuria|||0000-0002-2115-344X, Pérez-Hoyos, Santiago|||0000-0001-9797-4917, Salvador Velez, Fernando Maria|||0000-0002-0546-1354, Durà-Miralles, Xavier, Miarons, Marta|||0000-0001-7847-1580, Antón Pagarolas, Andrés, 1976-|||0000-0002-1476-0815, Eremiev, Simeón|||0000-0002-5494-183X, Sempere González, Abiu|||0000-0002-3347-9383, Monforte-Pallarés, Arnau|||0000-0002-5468-3885, Bosch-Nicolau, Pau|||0000-0002-7435-1829, Augustin Recio, Salvador|||0000-0002-3515-9033, Sampol, Júlia|||0000-0003-0939-7772, Guillén-Del-Castillo, Alfredo|||0000-0003-0626-507X, Almirante Gragera, Benito|||0000-0002-1189-2361
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:304119
Acceso en línea:https://ddd.uab.cat/record/304119
https://dx.doi.org/urn:doi:10.1016/j.medcle.2021.06.023
Access Level:acceso abierto
Palabra clave:Tocilizumab
COVID19
IL6
SARS-CoV-2
Immonomodulation
Viral pneumonia
Descripción
Sumario:Background: Modulation of the immune system to prevent lung injury is being widely used against the new coronavirus disease (COVID-19) despite the scarcity of evidence. Methods: We report the preliminary results from the Vall d'Hebron prospective cohort study at Vall d'Hebron University Hospital, in Barcelona (Spain), including all consecutive patients who had a confirmed infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and who were treated with tocilizumab until March 25th. The primary endpoint was mortality at 7 days after tocilizumab administration. Secondary endpoints were admission to the intensive care unit, development of ARDS and respiratory insufficiency among others. Results: 82 patients with COVID-19 received at least one dose of tocilizumab. The mean (± SD) age was 59.1 (19.8) years, 63% were male, 22% were of non-Spanish ancestry, and the median (IQR) age-adjusted Charlson index at baseline was 3 (1-4) points. Respiratory failure and ARDS developed in 62 (75.6%) and 45 (54.9%) patients, respectively. Median time from symptom onset to ARDS development was 8 (5-11) days. The median time from symptom onset to the first dose of tocilizumab was 9 (7-11) days. Mortality at 7 days was 26.8%. Hazard ratio for mortality was 3.3; 95% CI, 1.3 to 8.5 (age-adjusted hazard ratio for mortality 2.1; 95% CI, 0.8 to 5.8) if tocilizumab was administered after the onset of ARDS. Conclusion: Time from lung injury onset to tocilizumab administration may be critical to patient recovery. Our preliminary data could inform bedside decisions until more data from clinical trials becomes available.

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