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- Title
Outcomes in patients with severe COVID-19 disease treated with tocilizumab: a case–controlled study.
- Authors
Rojas-Marte, G; Khalid, M; Mukhtar, O; Hashmi, A T; Waheed, M A; Ehrlich, S; Aslam, A; Siddiqui, S; Agarwal, C; Malyshev, Y; Henriquez-Felipe, C; Sharma, D; Sharma, S; Chukwuka, N; Rodriguez, D C; Alliu, S; Le, J; Shani, J
- Abstract
Background COVID-19 is an ongoing threat to society. Patients who develop the most severe forms of the disease have high mortality. The interleukin-6 inhibitor tocilizumab has the potential to improve outcomes in these patients by preventing the development of cytokine release storm. Aims To evaluate the outcomes of patients with severe COVID-19 disease treated with the interleukin-6 inhibitor tocilizumab. Methods We conducted a retrospective, case–control, single-center study in patients with severe to critical COVID-19 disease treated with tocilizumab. Disease severity was defined based on the amount of oxygen supplementation required. The primary endpoint was the overall mortality. Secondary endpoints were mortality in non-intubated patients and mortality in intubated patients. Results A total of 193 patients were included in the study. Ninety-six patients received tocilizumab, while 97 served as the control group. The mean age was 60 years. Patients over 65 years represented 43% of the population. More patients in the tocilizumab group reported fever, cough and shortness of breath (83%, 80% and 96% vs. 73%, 69% and 71%, respectively). There was a non-statistically significant lower mortality in the treatment group (52% vs. 62.1%, P = 0.09). When excluding intubated patients, there was statistically significant lower mortality in patients treated with tocilizumab (6% vs. 27%, P = 0.024). Bacteremia was more common in the control group (24% vs. 13%, P = 0.43), while fungemia was similar for both (3% vs. 4%, P = 0.72). Conclusion Our study showed a non-statistically significant lower mortality in patients with severe to critical COVID-19 disease who received tocilizumab. When intubated patients were excluded, the use of tocilizumab was associated with lower mortality.
- Subjects
COVID-19; CYTOKINE release syndrome; DYSPNEA; FUNGEMIA; TOCILIZUMAB
- Publication
QJM: An International Journal of Medicine, 2020, Vol 113, Issue 8, p546
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hcaa206