tetano
Editor, Senior Moderator
Med Clin (Engl Ed)
. 2022 Jun 10;158(11):509-518.
doi: 10.1016/j.medcle.2021.06.023. Epub 2022 Jun 18.
Early outcomes in adults hospitalized with severe SARS-CoV-2 infection receiving tocilizumab
Adrián Sánchez-Montalvá[SUP] 1 2 3 [/SUP], Júlia Sellarés-Nadal[SUP] 1 [/SUP], Juan Espinosa-Pereiro[SUP] 1 2 [/SUP], Nuria Fernández-Hidalgo[SUP] 1 4 [/SUP], Santiago Pérez-Hoyos[SUP] 5 [/SUP], Fernando Salvador[SUP] 1 2 3 [/SUP], Xavier Durà[SUP] 1 [/SUP], Marta Miarons[SUP] 6 [/SUP], Andrés Antón[SUP] 7 4 [/SUP], Simeón Eremiev-Eremiev[SUP] 1 [/SUP], Abiu Sempere-González[SUP] 1 [/SUP], Arnau Monforte-Pallarés[SUP] 1 [/SUP], Pau Bosch-Nicolau[SUP] 1 [/SUP], Salvador Augustin[SUP] 8 [/SUP], Júlia Sampol[SUP] 9 [/SUP], Alfredo Guillén-Del-Castillo[SUP] 10 [/SUP], Benito Almirante[SUP] 1 4 [/SUP]
Affiliations
Abstract
in English, Spanish
Background: Modulation of the immune system to prevent lung injury is being widely used against the new coronavirus disease (COVID-19). The primary endpoint was mortality at 7 days after tocilizumab administration. Secondary endpoints were admission to the intensive care unit, development of ARDS and respiratory insufficiency among others.
Methods: We report the preliminary results from the Vall d'Hebron cohort study at Vall d'Hebron University Hospital, in Barcelona (Spain), including all consecutive patients who had a confirmed SARS-CoV-2 infection and who were treated with tocilizumab until March 25th.
Results: 82 patients with COVID-19 received at least one dose of tocilizumab. The mean (± SD) age was 59.1 (19.8) years, 63% were male, 22% were of non-Spanish ancestry, and the median (IQR) age-adjusted Charlson index at baseline was 3 (1-4) points. Respiratory failure and ARDS developed in 62 (75.6%) and 45 (54.9%) patients, respectively. Median time from symptom onset to ARDS development was 8 (5-11) days. Mortality at 7 days was 26.8%. Hazard ratio for mortality was 3.3; 95% CI, 1.3-8.5 (age-adjusted hazard ratio for mortality 2.1; 95% CI, 0.8-5.8) if tocilizumab was administered after the onset of ARDS.
Conclusion: Early administration of tocilizumab in patients needing oxygen supplementation may be critical to patient recovery. Our preliminary data could inform bedside decisions until more data regarding the precise timing in of initiation of the treatment with tocilizumab.
Keywords: COVID19; IL6; Immonomodulation; SARS-CoV-2; Tocilizumab; Viral pneumonia.
. 2022 Jun 10;158(11):509-518.
doi: 10.1016/j.medcle.2021.06.023. Epub 2022 Jun 18.
Early outcomes in adults hospitalized with severe SARS-CoV-2 infection receiving tocilizumab
Adrián Sánchez-Montalvá[SUP] 1 2 3 [/SUP], Júlia Sellarés-Nadal[SUP] 1 [/SUP], Juan Espinosa-Pereiro[SUP] 1 2 [/SUP], Nuria Fernández-Hidalgo[SUP] 1 4 [/SUP], Santiago Pérez-Hoyos[SUP] 5 [/SUP], Fernando Salvador[SUP] 1 2 3 [/SUP], Xavier Durà[SUP] 1 [/SUP], Marta Miarons[SUP] 6 [/SUP], Andrés Antón[SUP] 7 4 [/SUP], Simeón Eremiev-Eremiev[SUP] 1 [/SUP], Abiu Sempere-González[SUP] 1 [/SUP], Arnau Monforte-Pallarés[SUP] 1 [/SUP], Pau Bosch-Nicolau[SUP] 1 [/SUP], Salvador Augustin[SUP] 8 [/SUP], Júlia Sampol[SUP] 9 [/SUP], Alfredo Guillén-Del-Castillo[SUP] 10 [/SUP], Benito Almirante[SUP] 1 4 [/SUP]
Affiliations
- PMID: 35755602
- PMCID: PMC9213005
- DOI: 10.1016/j.medcle.2021.06.023
Abstract
in English, Spanish
Background: Modulation of the immune system to prevent lung injury is being widely used against the new coronavirus disease (COVID-19). The primary endpoint was mortality at 7 days after tocilizumab administration. Secondary endpoints were admission to the intensive care unit, development of ARDS and respiratory insufficiency among others.
Methods: We report the preliminary results from the Vall d'Hebron cohort study at Vall d'Hebron University Hospital, in Barcelona (Spain), including all consecutive patients who had a confirmed SARS-CoV-2 infection and who were treated with tocilizumab until March 25th.
Results: 82 patients with COVID-19 received at least one dose of tocilizumab. The mean (± SD) age was 59.1 (19.8) years, 63% were male, 22% were of non-Spanish ancestry, and the median (IQR) age-adjusted Charlson index at baseline was 3 (1-4) points. Respiratory failure and ARDS developed in 62 (75.6%) and 45 (54.9%) patients, respectively. Median time from symptom onset to ARDS development was 8 (5-11) days. Mortality at 7 days was 26.8%. Hazard ratio for mortality was 3.3; 95% CI, 1.3-8.5 (age-adjusted hazard ratio for mortality 2.1; 95% CI, 0.8-5.8) if tocilizumab was administered after the onset of ARDS.
Conclusion: Early administration of tocilizumab in patients needing oxygen supplementation may be critical to patient recovery. Our preliminary data could inform bedside decisions until more data regarding the precise timing in of initiation of the treatment with tocilizumab.
Keywords: COVID19; IL6; Immonomodulation; SARS-CoV-2; Tocilizumab; Viral pneumonia.