Details

Autor(en) / Beteiligte

• Rubio-Rivas, Manuel
• Ronda, Mar
• Padulles, Ariadna
• Mitjavila, Francesca
• Riera-Mestre, Antoni
• García-Forero, Carlos
• Iriarte, Adriana
• Mora, Jose M.
• Padulles, Nuria
• Gonzalez, Monica
• Solanich, Xavier
• Gasa, Merce
• Suarez-Cuartin, Guillermo
• Sabater, Joan
• Perez-Fernandez, Xose L.
• Santacana, Eugenia
• Leiva, Elisabet
• Ariza-Sole, Albert
• Dallaglio, Paolo D.
• Quero, Maria
• Soriano, Antonio
• Pasqualetto, Alberto
• Koo, Maylin
• Esteve, Virginia
• Antoli, Arnau
• Moreno-Gonzalez, Rafael
• Yun, Sergi
• Cerda, Pau
• Llaberia, Mariona
• Formiga, Francesc
• Fanlo, Marta
• Montero, Abelardo
• Chivite, David
• Capdevila, Olga
• Bolao, Ferran
• Pinto, Xavier
• Llop, Josep
• Sabate, Antoni
• Guardiola, Jordi
• Cruzado, Josep M.
• Comin-Colet, Josep
• Santos, Salud
• Jodar, Ramon
• Corbella, Xavier

Titel

Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness

Ist Teil von

• International journal of infectious diseases, 2020-12, Vol.101, p.290-297

Ort / Verlag

Canada: Elsevier Ltd

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• •Dexamethasone or alternative steroids are recommended in severe COVID-19 cases.•The use of tocilizumab in COVID-19 cases, with or without steroids, is still controversial.•Risk for mortality was assessed in 186 COVID-19 patients receiving tocilizumab.•Mortality was associated with older age, chronic heart failure, and liver disease.•In tocilizumab-treated patients, the additional use of steroids was beneficial. To assess the characteristics and risk factors for mortality in patients with severe coronavirus disease-2019 (COVID-19) treated with tocilizumab (TCZ), alone or in combination with corticosteroids (CS). From March 17 to April 7, 2020, a real-world observational retrospective analysis of consecutive hospitalized adult patients receiving TCZ to treat severe COVID-19 was conducted at our 750-bed university hospital. The main outcome was all-cause in-hospital mortality. A total of 1,092 patients with COVID-19 were admitted during the study period. Of them, 186 (17%) were treated with TCZ, of which 129 (87.8%) in combination with CS. Of the total 186 patients, 155 (83.3 %) patients were receiving noninvasive ventilation when TCZ was initiated. Mean time from symptoms onset and hospital admission to TCZ use was 12 (±4.3) and 4.3 days (±3.4), respectively. Overall, 147 (79%) survived and 39 (21%) died. By multivariate analysis, mortality was associated with older age (HR = 1.09, p < 0.001), chronic heart failure (HR = 4.4, p = 0.003), and chronic liver disease (HR = 4.69, p = 0.004). The use of CS, in combination with TCZ, was identified as a protective factor against mortality (HR = 0.26, p < 0.001) in such severe COVID-19 patients receiving TCZ. No serious superinfections were observed after a 30-day follow-up. In patients with severe COVID-19 receiving TCZ due to systemic host-immune inflammatory response syndrome, the use of CS in addition to TCZ therapy, showed a beneficial effect in preventing in-hospital mortality.