tetano
Editor, Senior Moderator
Int J Infect Dis
. 2022 May 20;S1201-9712(22)00302-2.
doi: 10.1016/j.ijid.2022.05.038. Online ahead of print.
The Safety and Efficacy of Tocilizumab in Older Adult Critically Ill Patients with Coronavirus Disease 2019 (COVID-19): A Multi-center, Cohort Study
Ghazwa B Korayem[SUP] 1 [/SUP], Ohoud Aljuhani[SUP] 2 [/SUP], Ali F Altebainawi[SUP] 3 [/SUP], Abdulrahman I Al Shaya[SUP] 4 [/SUP], Lina I Alnajjar[SUP] 1 [/SUP], Abdulrahman Alissa[SUP] 5 [/SUP], Mohammed Aldhaeefi[SUP] 4 [/SUP], Raed Kensara[SUP] 6 [/SUP], Hessa Al Muqati[SUP] 7 [/SUP], Abdulmohsen Alhuwahmel[SUP] 8 [/SUP], Omar Alhuthaili[SUP] 8 [/SUP], Ramesh Vishwakarma[SUP] 9 [/SUP], Namareq Aldardeer[SUP] 10 [/SUP], Khalid Eljaaly[SUP] 11 [/SUP], Aisha Alharbi[SUP] 12 [/SUP], Shmeylan Al Harbi[SUP] 4 [/SUP], Abdulmalik Al Katheri[SUP] 4 [/SUP], Abdulkareem M Al Bekairy[SUP] 4 [/SUP], Ahmed Aljedai[SUP] 13 [/SUP], Khalid Al Sulaiman[SUP] 14 [/SUP]
Affiliations
Abstract
Background: Evidence supports Tocilizumab (TCZ) benefit and safety in adult patients with severe COVID-19. However, its effectiveness in critically ill older adult patients remains questionable. Thus, the study aimed to evaluate the safety and efficacy of TCZ in older critically ill patients with COVID-19.
Method: A multicenter, retrospective study for all critically ill older adults (aged ≥ 65 years old) with confirmed COVID-19 infection and admitted to the intensive care units. Eligible patients were categorized into two groups based on TCZ use during ICU stay (Control vs. TCZ). Propensity score matching was used (1:1 ratio) based on the selected criteria. The primary outcome was in-hospital mortality.
Results: A total of 368 older adults critically ill patients were included in the study. Fifty-one patients (13.8%) received TCZ. The in-hospital mortality was lower in the TCZ treated group HR (0.41 [95% CI 0.22-0.76], p-value =0.005). Patients who received TCZ had a lower odd of respiratory failure requiring mechanical ventilation OR (0.32 [95% CI 0.10-0.98]), p-value=0.04). No statistically significant differences were found between the two groups for 30- days mortality, ventilator-free days, length of stay, and complications during ICU stay.
Conclusion: TCZ use in older adults critically ill patients with COVID-19 is associated with lower in-hospital mortality and similar safety profile.
Keywords: COVID-19; Older adult; SARS-CoV-2; Tocilizumab; mortality; respiratory failure.
. 2022 May 20;S1201-9712(22)00302-2.
doi: 10.1016/j.ijid.2022.05.038. Online ahead of print.
The Safety and Efficacy of Tocilizumab in Older Adult Critically Ill Patients with Coronavirus Disease 2019 (COVID-19): A Multi-center, Cohort Study
Ghazwa B Korayem[SUP] 1 [/SUP], Ohoud Aljuhani[SUP] 2 [/SUP], Ali F Altebainawi[SUP] 3 [/SUP], Abdulrahman I Al Shaya[SUP] 4 [/SUP], Lina I Alnajjar[SUP] 1 [/SUP], Abdulrahman Alissa[SUP] 5 [/SUP], Mohammed Aldhaeefi[SUP] 4 [/SUP], Raed Kensara[SUP] 6 [/SUP], Hessa Al Muqati[SUP] 7 [/SUP], Abdulmohsen Alhuwahmel[SUP] 8 [/SUP], Omar Alhuthaili[SUP] 8 [/SUP], Ramesh Vishwakarma[SUP] 9 [/SUP], Namareq Aldardeer[SUP] 10 [/SUP], Khalid Eljaaly[SUP] 11 [/SUP], Aisha Alharbi[SUP] 12 [/SUP], Shmeylan Al Harbi[SUP] 4 [/SUP], Abdulmalik Al Katheri[SUP] 4 [/SUP], Abdulkareem M Al Bekairy[SUP] 4 [/SUP], Ahmed Aljedai[SUP] 13 [/SUP], Khalid Al Sulaiman[SUP] 14 [/SUP]
Affiliations
- PMID: 35605948
- DOI: 10.1016/j.ijid.2022.05.038
Abstract
Background: Evidence supports Tocilizumab (TCZ) benefit and safety in adult patients with severe COVID-19. However, its effectiveness in critically ill older adult patients remains questionable. Thus, the study aimed to evaluate the safety and efficacy of TCZ in older critically ill patients with COVID-19.
Method: A multicenter, retrospective study for all critically ill older adults (aged ≥ 65 years old) with confirmed COVID-19 infection and admitted to the intensive care units. Eligible patients were categorized into two groups based on TCZ use during ICU stay (Control vs. TCZ). Propensity score matching was used (1:1 ratio) based on the selected criteria. The primary outcome was in-hospital mortality.
Results: A total of 368 older adults critically ill patients were included in the study. Fifty-one patients (13.8%) received TCZ. The in-hospital mortality was lower in the TCZ treated group HR (0.41 [95% CI 0.22-0.76], p-value =0.005). Patients who received TCZ had a lower odd of respiratory failure requiring mechanical ventilation OR (0.32 [95% CI 0.10-0.98]), p-value=0.04). No statistically significant differences were found between the two groups for 30- days mortality, ventilator-free days, length of stay, and complications during ICU stay.
Conclusion: TCZ use in older adults critically ill patients with COVID-19 is associated with lower in-hospital mortality and similar safety profile.
Keywords: COVID-19; Older adult; SARS-CoV-2; Tocilizumab; mortality; respiratory failure.