Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness

Objectives: To assess the characteristics and risk factors for mortality in patients with severe coronavirus disease-2019 (COVID-19) treated with tocilizumab (TCZ), alone or in combination with corticosteroids (CS). Methods: From March 17 to April 7, 2020, a real-world observational retrospective an...

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Autores: Santos Pérez, Salud, Formiga Pérez, Francesc, Pintó Sala, Xavier, Padullés Zamora, Núria, Ariza Solé, Albert, Cruzado, Josep Ma., Gasa Galmés, Mercè, Sabaté Pes, Antoni, Guardiola, Jordi
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/177892
Acesso em linha:https://hdl.handle.net/2445/177892
Access Level:acceso abierto
Palavra-chave:COVID-19
Mortalitat
Mortality
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spelling Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illnessSantos Pérez, SaludFormiga Pérez, FrancescPintó Sala, XavierPadullés Zamora, NúriaAriza Solé, AlbertCruzado, Josep Ma.Gasa Galmés, MercèSabaté Pes, AntoniGuardiola, JordiCOVID-19MortalitatCOVID-19MortalityObjectives: To assess the characteristics and risk factors for mortality in patients with severe coronavirus disease-2019 (COVID-19) treated with tocilizumab (TCZ), alone or in combination with corticosteroids (CS). Methods: From March 17 to April 7, 2020, a real-world observational retrospective analysis of consecutive hospitalized adult patients receiving TCZ to treat severe COVID-19 was conducted at our 750-bed university hospital. The main outcome was all-cause in-hospital mortality. Results: A total of 1,092 patients with COVID-19 were admitted during the study period. Of them, 186 (17%) were treated with TCZ, of which 129 (87.8%) in combination with CS. Of the total 186 patients, 155 (83.3 %) patients were receiving noninvasive ventilation when TCZ was initiated. Mean time from symptoms onset and hospital admission to TCZ use was 12 (±4.3) and 4.3 days (±3.4), respectively. Overall, 147 (79%) survived and 39 (21%) died. By multivariate analysis, mortality was associated with older age (HR = 1.09, p < 0.001), chronic heart failure (HR = 4.4, p = 0.003), and chronic liver disease (HR = 4.69, p = 0.004). The use of CS, in combination with TCZ, was identified as a protective factor against mortality (HR = 0.26, p < 0.001) in such severe COVID-19 patients receiving TCZ. No serious superinfections were observed after a 30-day follow-up. Conclusions: In patients with severe COVID-19 receiving TCZ due to systemic host-immune inflammatory response syndrome, the use of CS in addition to TCZ therapy, showed a beneficial effect in preventing in-hospital mortality.Elsevier B.V.2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/177892Articles publicats en revistes (Ciències Clíniques)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.ijid.2020.09.1486International Journal of Infectious Diseases, 2020, vol. 101, p. 290-297https://doi.org/10.1016/j.ijid.2020.09.1486cc-by-nc-nd (c) Santos Pérez, Salud et al., 2020https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1778922026-05-27T06:46:51Z
dc.title.none.fl_str_mv Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness
title Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness
spellingShingle Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness
Santos Pérez, Salud
COVID-19
Mortalitat
COVID-19
Mortality
title_short Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness
title_full Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness
title_fullStr Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness
title_full_unstemmed Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness
title_sort Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness
dc.creator.none.fl_str_mv Santos Pérez, Salud
Formiga Pérez, Francesc
Pintó Sala, Xavier
Padullés Zamora, Núria
Ariza Solé, Albert
Cruzado, Josep Ma.
Gasa Galmés, Mercè
Sabaté Pes, Antoni
Guardiola, Jordi
author Santos Pérez, Salud
author_facet Santos Pérez, Salud
Formiga Pérez, Francesc
Pintó Sala, Xavier
Padullés Zamora, Núria
Ariza Solé, Albert
Cruzado, Josep Ma.
Gasa Galmés, Mercè
Sabaté Pes, Antoni
Guardiola, Jordi
author_role author
author2 Formiga Pérez, Francesc
Pintó Sala, Xavier
Padullés Zamora, Núria
Ariza Solé, Albert
Cruzado, Josep Ma.
Gasa Galmés, Mercè
Sabaté Pes, Antoni
Guardiola, Jordi
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
Mortalitat
COVID-19
Mortality
topic COVID-19
Mortalitat
COVID-19
Mortality
description Objectives: To assess the characteristics and risk factors for mortality in patients with severe coronavirus disease-2019 (COVID-19) treated with tocilizumab (TCZ), alone or in combination with corticosteroids (CS). Methods: From March 17 to April 7, 2020, a real-world observational retrospective analysis of consecutive hospitalized adult patients receiving TCZ to treat severe COVID-19 was conducted at our 750-bed university hospital. The main outcome was all-cause in-hospital mortality. Results: A total of 1,092 patients with COVID-19 were admitted during the study period. Of them, 186 (17%) were treated with TCZ, of which 129 (87.8%) in combination with CS. Of the total 186 patients, 155 (83.3 %) patients were receiving noninvasive ventilation when TCZ was initiated. Mean time from symptoms onset and hospital admission to TCZ use was 12 (±4.3) and 4.3 days (±3.4), respectively. Overall, 147 (79%) survived and 39 (21%) died. By multivariate analysis, mortality was associated with older age (HR = 1.09, p < 0.001), chronic heart failure (HR = 4.4, p = 0.003), and chronic liver disease (HR = 4.69, p = 0.004). The use of CS, in combination with TCZ, was identified as a protective factor against mortality (HR = 0.26, p < 0.001) in such severe COVID-19 patients receiving TCZ. No serious superinfections were observed after a 30-day follow-up. Conclusions: In patients with severe COVID-19 receiving TCZ due to systemic host-immune inflammatory response syndrome, the use of CS in addition to TCZ therapy, showed a beneficial effect in preventing in-hospital mortality.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/177892
url https://hdl.handle.net/2445/177892
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.ijid.2020.09.1486
International Journal of Infectious Diseases, 2020, vol. 101, p. 290-297
https://doi.org/10.1016/j.ijid.2020.09.1486
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Santos Pérez, Salud et al., 2020
https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Santos Pérez, Salud et al., 2020
https://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 B.V.
publisher.none.fl_str_mv Elsevier B.V.
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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