Tags

Type your tag names separated by a space and hit enter

Experience with tocilizumab in severe COVID-19 pneumonia after 80 days of follow-up: A retrospective cohort study.
J Autoimmun. 2020 11; 114:102523.JA

Abstract

OBJECTIVES

To describe the clinical characteristics and predictors of major outcomes in patients treated with tocilizumab (TCZ) for severe COVID-19 pneumonia.

PATIENTS AND METHODS

Case series of all sequential patients with severe COVID-19 pneumonia treated with TCZ at an Academic Spanish hospital (March 12 - May 2, 2020). Clinical outcomes: death, length of hospital stay. An early clinical response to TCZ (48-72 h after the administration) was assessed by variations in respiratory function markers, Brescia COVID Respiratory Severity Scale (BCRSS), inflammatory parameters, and patients' and physicians' opinion. Associations were tested by multiple logistic regression.

RESULTS

From a cohort of 236 patients, 77 patients treated with TCZ were included (median age 62 years (IQR 53.0-72.0), 64.9% were males), 42.9% had Charlson index ≥3; hypertension (41.6%), obesity (34.7%), and diabetes (20.8%). Median follow-up was 83.0 days (78.0-86.5), no patient was readmitted. ICU admission was required for 42 (54.5%), invasive mechanical ventilation in 38 (49.4%) and 10 patients died (12.9% global, 23.8% at ICU admitted). After multivariate adjustment, TCZ response by BCRSS (OR 0.03 (0.01-0.68), p = 0.028), and Charlson index (OR 3.54 (1.20-10.44), p = 0.022) has been identified as independent factors associated with mortality. Median of hospital stay was 16.0 days (11.0-23.0); BCRSS, physician subjective and D-dimer response were associated with shorter hospitalization stay.

CONCLUSIONS

In a Mediterranean cohort, use of tocilizumab for severe COVID-19 show 12.9% of mortality. Early TCZ-response by BCRSS and low comorbidity were associated with increased survival. Early TCZ-response was related to shorter median hospital stay.

Authors+Show Affiliations

Endocrinology and Nutrition Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain; Clinical Medicine Department, Miguel Hernández University, Elche, Spain. Electronic address: omorenoperez@hotmail.es.Clinical Medicine Department, Miguel Hernández University, Elche, Spain; Rheumatology Department, Alicante General University Hospital Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: drmarianoandres@gmail.com.Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: jmleonr@hotmail.com.Preventive Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: sanchez_jos@gva.es.Microbiology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain; Miguel Hernández University, Elche, Spain. Electronic address: rodriguez_juadia@gva.es.Internal Medicine Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: sanchez_rosmar@gva.es.Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: raquelgsevila@gmail.com.Clinical Medicine Department, Miguel Hernández University, Elche, Spain; Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: boix_vic@gva.es.Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: joangilcarbonell@gmail.com.Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: merino_luc@gva.es.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32690352

Citation

Moreno-Pérez, Oscar, et al. "Experience With Tocilizumab in Severe COVID-19 Pneumonia After 80 Days of Follow-up: a Retrospective Cohort Study." Journal of Autoimmunity, vol. 114, 2020, p. 102523.
Moreno-Pérez O, Andres M, Leon-Ramirez JM, et al. Experience with tocilizumab in severe COVID-19 pneumonia after 80 days of follow-up: A retrospective cohort study. J Autoimmun. 2020;114:102523.
Moreno-Pérez, O., Andres, M., Leon-Ramirez, J. M., Sánchez-Payá, J., Rodríguez, J. C., Sánchez, R., García-Sevila, R., Boix, V., Gil, J., & Merino, E. (2020). Experience with tocilizumab in severe COVID-19 pneumonia after 80 days of follow-up: A retrospective cohort study. Journal of Autoimmunity, 114, 102523. https://doi.org/10.1016/j.jaut.2020.102523
Moreno-Pérez O, et al. Experience With Tocilizumab in Severe COVID-19 Pneumonia After 80 Days of Follow-up: a Retrospective Cohort Study. J Autoimmun. 2020;114:102523. PubMed PMID: 32690352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Experience with tocilizumab in severe COVID-19 pneumonia after 80 days of follow-up: A retrospective cohort study. AU - Moreno-Pérez,Oscar, AU - Andres,Mariano, AU - Leon-Ramirez,Jose-Manuel, AU - Sánchez-Payá,José, AU - Rodríguez,Juan Carlos, AU - Sánchez,Rosario, AU - García-Sevila,Raquel, AU - Boix,Vicente, AU - Gil,Joan, AU - Merino,Esperanza, Y1 - 2020/07/16/ PY - 2020/06/17/received PY - 2020/07/08/revised PY - 2020/07/09/accepted PY - 2020/7/22/pubmed PY - 2020/7/22/medline PY - 2020/7/22/entrez KW - COVID19 pneumonia KW - Case series KW - Mechanical invasive ventilation KW - Mortality KW - Tocilizumab SP - 102523 EP - 102523 JF - Journal of autoimmunity JO - J Autoimmun VL - 114 N2 - OBJECTIVES: To describe the clinical characteristics and predictors of major outcomes in patients treated with tocilizumab (TCZ) for severe COVID-19 pneumonia. PATIENTS AND METHODS: Case series of all sequential patients with severe COVID-19 pneumonia treated with TCZ at an Academic Spanish hospital (March 12 - May 2, 2020). Clinical outcomes: death, length of hospital stay. An early clinical response to TCZ (48-72 h after the administration) was assessed by variations in respiratory function markers, Brescia COVID Respiratory Severity Scale (BCRSS), inflammatory parameters, and patients' and physicians' opinion. Associations were tested by multiple logistic regression. RESULTS: From a cohort of 236 patients, 77 patients treated with TCZ were included (median age 62 years (IQR 53.0-72.0), 64.9% were males), 42.9% had Charlson index ≥3; hypertension (41.6%), obesity (34.7%), and diabetes (20.8%). Median follow-up was 83.0 days (78.0-86.5), no patient was readmitted. ICU admission was required for 42 (54.5%), invasive mechanical ventilation in 38 (49.4%) and 10 patients died (12.9% global, 23.8% at ICU admitted). After multivariate adjustment, TCZ response by BCRSS (OR 0.03 (0.01-0.68), p = 0.028), and Charlson index (OR 3.54 (1.20-10.44), p = 0.022) has been identified as independent factors associated with mortality. Median of hospital stay was 16.0 days (11.0-23.0); BCRSS, physician subjective and D-dimer response were associated with shorter hospitalization stay. CONCLUSIONS: In a Mediterranean cohort, use of tocilizumab for severe COVID-19 show 12.9% of mortality. Early TCZ-response by BCRSS and low comorbidity were associated with increased survival. Early TCZ-response was related to shorter median hospital stay. SN - 1095-9157 UR - https://www.unboundmedicine.com/medline/citation/32690352/Experience_with_tocilizumab_in_severe_COVID_19_pneumonia_after_80_days_of_follow_up:_A_retrospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0896-8411(20)30147-5 DB - PRIME DP - Unbound Medicine ER -