Details

Autor(en) / Beteiligte

• Capra, Ruggero
• De Rossi, Nicola
• Mattioli, Flavia
• Romanelli, Giuseppe
• Scarpazza, Cristina
• Sormani, Maria Pia
• Cossi, Stefania

Titel

Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia

Ist Teil von

• European journal of internal medicine, 2020-06, Vol.76, p.31-35

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• •Pneumonia with respiratory failure represents the main cause of death in COVID-19.•Hyperinflammation plays an important role in COVID-19 lung damage.•Tocilizumab might be helpful to treat COVID-19 related pneumonia.•8% vs 57% of deaths were observed in patients treated or not treated with tocilizumab.•Early administration of tocilizumab drastically reduced mortality rate in our sample.•Tocilizumab might prevent excessive lung damage and death in patients with COVID-19. Pneumonia with respiratory failure represents the main cause of death in COVID-19, where hyper inflammation plays an important role in lung damage. This study aims to evaluate if tocilizumab, an anti-soluble IL-6 receptor monoclonal antibody, reduces patients’ mortality. 85 consecutive patients admitted to the Montichiari Hospital (Italy) with COVID-19 related pneumonia and respiratory failure, not needing mechanical ventilation, were included if satisfying at least one among: respiratory rate ≥ 30 breaths/min, peripheral capillary oxygen saturation ≤ 93% or PaO2/FiO2<=300 mmHg. Patients admitted before March 13th (n=23) were prescribed the standard therapy (hydroxychloroquine, lopinavir and ritonavir) and were considered controls. On March 13th tocilizumab was available and patients admitted thereafter (n=62) received tocilizumab once within 4 days from admission, plus the standard care. Patients receiving tocilizumab showed significantly greater survival rate as compared to control patients (hazard ratio for death, 0.035; 95% confidence interval [CI], 0.004 to 0.347; p = 0.004), adjusting for baseline clinical characteristics. Two out of 62 patients of the tocilizumab group and 11 out of 23 in the control group died. 92% and 42.1% of the discharged patients in the tocilizumab and control group respectively, recovered. The respiratory function resulted improved in 64.8% of the observations in tocilizumab patients who were still hospitalized, whereas 100% of controls worsened and needed mechanical ventilation. No infections were reported. Tocilizumab results to have a positive impact if used early during Covid-19 pneumonia with severe respiratory syndrome in terms of increased survival and favorable clinical course.