Tags

Type your tag names separated by a space and hit enter

Safety and efficacy of tocilizumab in the treatment of severe acute respiratory syndrome coronavirus-2 pneumonia: A retrospective cohort study.
Indian J Med Microbiol. 2020 Jan-Mar; 38(1):117-123.IJ

Abstract

Background

Cytokine release storm (CRS) in severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) is thought to be the cause for organ damage and death which is independent of the actual viral burden. Tocilizumab (TCZ), an interleukin-6 receptor antagonist, is approved for the treatment of CRS. We describe the efficacy and safety of TCZ in SARS CoV-2 pneumonia.

Methods

This retrospective study was conducted at a tertiary care hospital from April 20 2020 to May 21 2020. The primary endpoint was the cumulative incidence of a composite of either need for admission to the intensive care unit (ICU) with invasive mechanical ventilation or death. Safety outcomes included an increase in liver transaminases and/or evidence of infection.

Results

A total of 20 patients received TCZ during the study period. The median age was 54 years (95% confidence interval [CI] 47-63). About 85% of the patients were male. Nearly 70% of the patients had at least one comorbidity. About 55% required ICU admission. The median duration of ICU stay was 11 days (95% CI: 3-13 days). The cumulative incidence of the requirement for mechanical ventilation, clinical improvement and mortality was 11% (95% CI: 0.03%-1%), 74% (95% CI 37%-89%) and 25% (95% CI: 11%-63%), respectively. There was no difference in outcomes according to age, gender or computed tomography severity score. Asymptomatic transaminitis was the most common drug reaction (55%), and one patient developed bacteraemia.

Conclusions

TCZ is likely a safe and effective modality of treatment for improving clinical and laboratory parameters of SARS CoV-2 patients with a reduction in ICU stay and ventilatory care need.

Authors+Show Affiliations

Department of Internal Medicine, Division of Infectious Diseases, Morsani College of Medicine, University of South Florida, Tampa, USA.Department of Infectious Diseases, Sterling Hospital, Ahmedabad, Gujarat, India.Department of Infectious Diseases, Sterling Hospital, Ahmedabad, Gujarat, India.Department of Infectious Diseases, Sterling Hospital, Ahmedabad, Gujarat, India.Department of Pulmonary and Critical Care Medicine, Sterling Hospital, Ahmedabad, Gujarat, India.Department of Pulmonary and Critical Care Medicine, Sterling Hospital, Ahmedabad, Gujarat, India.Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, USA.Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32719218

Citation

Patel, Atul, et al. "Safety and Efficacy of Tocilizumab in the Treatment of Severe Acute Respiratory Syndrome Coronavirus-2 Pneumonia: a Retrospective Cohort Study." Indian Journal of Medical Microbiology, vol. 38, no. 1, 2020, pp. 117-123.
Patel A, Shah K, Dharsandiya M, et al. Safety and efficacy of tocilizumab in the treatment of severe acute respiratory syndrome coronavirus-2 pneumonia: A retrospective cohort study. Indian J Med Microbiol. 2020;38(1):117-123.
Patel, A., Shah, K., Dharsandiya, M., Patel, K., Patel, T., Patel, M., Reljic, T., & Kumar, A. (2020). Safety and efficacy of tocilizumab in the treatment of severe acute respiratory syndrome coronavirus-2 pneumonia: A retrospective cohort study. Indian Journal of Medical Microbiology, 38(1), 117-123. https://doi.org/10.4103/ijmm.IJMM_20_298
Patel A, et al. Safety and Efficacy of Tocilizumab in the Treatment of Severe Acute Respiratory Syndrome Coronavirus-2 Pneumonia: a Retrospective Cohort Study. Indian J Med Microbiol. 2020 Jan-Mar;38(1):117-123. PubMed PMID: 32719218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety and efficacy of tocilizumab in the treatment of severe acute respiratory syndrome coronavirus-2 pneumonia: A retrospective cohort study. AU - Patel,Atul, AU - Shah,Kinjal, AU - Dharsandiya,Mitkumar, AU - Patel,Ketan, AU - Patel,Tushar, AU - Patel,Mukesh, AU - Reljic,Tea, AU - Kumar,Ambuj, PY - 2020/7/29/entrez PY - 2020/7/29/pubmed PY - 2020/8/5/medline KW - COVID-19 KW - Coronavirus KW - cytokine release storm KW - severe acute respiratory syndrome coronavirus-2 KW - tocilizumab SP - 117 EP - 123 JF - Indian journal of medical microbiology JO - Indian J Med Microbiol VL - 38 IS - 1 N2 - Background: Cytokine release storm (CRS) in severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) is thought to be the cause for organ damage and death which is independent of the actual viral burden. Tocilizumab (TCZ), an interleukin-6 receptor antagonist, is approved for the treatment of CRS. We describe the efficacy and safety of TCZ in SARS CoV-2 pneumonia. Methods: This retrospective study was conducted at a tertiary care hospital from April 20 2020 to May 21 2020. The primary endpoint was the cumulative incidence of a composite of either need for admission to the intensive care unit (ICU) with invasive mechanical ventilation or death. Safety outcomes included an increase in liver transaminases and/or evidence of infection. Results: A total of 20 patients received TCZ during the study period. The median age was 54 years (95% confidence interval [CI] 47-63). About 85% of the patients were male. Nearly 70% of the patients had at least one comorbidity. About 55% required ICU admission. The median duration of ICU stay was 11 days (95% CI: 3-13 days). The cumulative incidence of the requirement for mechanical ventilation, clinical improvement and mortality was 11% (95% CI: 0.03%-1%), 74% (95% CI 37%-89%) and 25% (95% CI: 11%-63%), respectively. There was no difference in outcomes according to age, gender or computed tomography severity score. Asymptomatic transaminitis was the most common drug reaction (55%), and one patient developed bacteraemia. Conclusions: TCZ is likely a safe and effective modality of treatment for improving clinical and laboratory parameters of SARS CoV-2 patients with a reduction in ICU stay and ventilatory care need. SN - 1998-3646 UR - https://www.unboundmedicine.com/medline/citation/32719218/Safety_and_efficacy_of_tocilizumab_in_the_treatment_of_severe_acute_respiratory_syndrome_coronavirus_2_pneumonia:_A_retrospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/IndianJMedMicrobiol_2020_38_1_117_290693 DB - PRIME DP - Unbound Medicine ER -