tetano
Editor, Senior Moderator
One Health
. 2021 Jan 5;100214.
doi: 10.1016/j.onehlt.2021.100214. Online ahead of print.
Matched cohort study on the efficacy of tocilizumab in patients with COVID-19
Alejandro Rodr?guez-Molinero[SUP] 1 [/SUP], Carlos P?rez-L?pez[SUP] 2 [/SUP], C?sar G?lvez-Barr?n[SUP] 1 [/SUP], Antonio Mi?arro[SUP] 3 [/SUP], Oscar Macho[SUP] 1 [/SUP], Gabriela F L?pez[SUP] 1 [/SUP], Maria Teresa Robles[SUP] 1 [/SUP], Maria Dolores Dapena[SUP] 1 [/SUP], Sergi Mart?nez[SUP] 1 [/SUP], Ezequiel Rodr?guez Gullello[SUP] 1 [/SUP], Isabel Collado P?rez[SUP] 1 [/SUP], COVID-19 research group of CSAPG
Affiliations
Abstract
Tocilizumab has been proposed as a treatment for the new disease COVID-19, however, there is not enough scientific evidence to support this treatment. The objective of this study is to analyze whether the use of tocilizumab is associated with respiratory improvement and a shorter time to discharge in patients with COVID-19 and lung involvement. Methods: Observational study on a cohort of 418 patients, admitted to three county hospitals in Catalonia (Spain). Patients admitted consecutively were included and followed until discharge or up to 30 days of admission. A sub-cohort of patients treated with tocilizumab and a sub-cohort of control patients were identified, matched by a large number of risk factors and clinical variables. Sub-cohorts were also matched by the number of other treatments for COVID-19 that patients received. Increment in SAFI (inspired oxygen fraction / saturation) 48 h after the start of treatment, and time to discharge, were the primary outcomes. Mortality, which was a secondary outcome, was analyzed in the total cohort, by using logistic regression models, adjusted by confounders. Results: There were 96 patients treated with tocilizumab. Of them, 22 patients could be matched with an equivalent number of control patients. The increment in SAFI from baseline to 48 h of treatment, was not significantly different between groups (tocilizumab: -0.04; control: 0.09; p = 0.636). Also, no difference in time to discharge was found between the two sub-cohorts (logrank test: p = 0.472). The logistic regression models, did not show an effect of tocilizumab on mortality (OR 0.99; p = 0.990). Conclusions: We did not find a clinical benefit associated with the use tocilizumab, in terms of respiratory function at 48 h of treatment, or time to discharge.
Keywords: Cohort; Coronavirus; Efficacy; Observational study; Sars-cov-2; Tocilizumab.
. 2021 Jan 5;100214.
doi: 10.1016/j.onehlt.2021.100214. Online ahead of print.
Matched cohort study on the efficacy of tocilizumab in patients with COVID-19
Alejandro Rodr?guez-Molinero[SUP] 1 [/SUP], Carlos P?rez-L?pez[SUP] 2 [/SUP], C?sar G?lvez-Barr?n[SUP] 1 [/SUP], Antonio Mi?arro[SUP] 3 [/SUP], Oscar Macho[SUP] 1 [/SUP], Gabriela F L?pez[SUP] 1 [/SUP], Maria Teresa Robles[SUP] 1 [/SUP], Maria Dolores Dapena[SUP] 1 [/SUP], Sergi Mart?nez[SUP] 1 [/SUP], Ezequiel Rodr?guez Gullello[SUP] 1 [/SUP], Isabel Collado P?rez[SUP] 1 [/SUP], COVID-19 research group of CSAPG
Affiliations
- PMID: 33426262
- PMCID: PMC7784546
- DOI: 10.1016/j.onehlt.2021.100214
Abstract
Tocilizumab has been proposed as a treatment for the new disease COVID-19, however, there is not enough scientific evidence to support this treatment. The objective of this study is to analyze whether the use of tocilizumab is associated with respiratory improvement and a shorter time to discharge in patients with COVID-19 and lung involvement. Methods: Observational study on a cohort of 418 patients, admitted to three county hospitals in Catalonia (Spain). Patients admitted consecutively were included and followed until discharge or up to 30 days of admission. A sub-cohort of patients treated with tocilizumab and a sub-cohort of control patients were identified, matched by a large number of risk factors and clinical variables. Sub-cohorts were also matched by the number of other treatments for COVID-19 that patients received. Increment in SAFI (inspired oxygen fraction / saturation) 48 h after the start of treatment, and time to discharge, were the primary outcomes. Mortality, which was a secondary outcome, was analyzed in the total cohort, by using logistic regression models, adjusted by confounders. Results: There were 96 patients treated with tocilizumab. Of them, 22 patients could be matched with an equivalent number of control patients. The increment in SAFI from baseline to 48 h of treatment, was not significantly different between groups (tocilizumab: -0.04; control: 0.09; p = 0.636). Also, no difference in time to discharge was found between the two sub-cohorts (logrank test: p = 0.472). The logistic regression models, did not show an effect of tocilizumab on mortality (OR 0.99; p = 0.990). Conclusions: We did not find a clinical benefit associated with the use tocilizumab, in terms of respiratory function at 48 h of treatment, or time to discharge.
Keywords: Cohort; Coronavirus; Efficacy; Observational study; Sars-cov-2; Tocilizumab.