Early outcomes adults hospitalized with severe COVID-19 receiving tocilizumab
Sánchez-Montalvá, Adrián (Hospital Universitari Vall d'Hebron)
Sellarès-Nadal, Júlia (Hospital Universitari Vall d'Hebron)
Espinosa-Pereiro, Juan (Hospital Universitari Vall d'Hebron)
Fernández-Hidalgo, Nuria (Hospital Universitari Vall d'Hebron)
Pérez-Hoyos, Santiago (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Salvador, Fernando (Hospital Universitari Vall d'Hebron)
Durà-Miralles, Xavier (Hospital Universitari Vall d'Hebron)
Miarons, Marta (Hospital Universitari Vall d'Hebron)
Antón Pagarolas, Andrés, 1976- 1976- (Hospital Universitari Vall d'Hebron)
Eremiev, Simeón (Hospital Universitari Vall d'Hebron)
Sempere González, Abiu (Hospital Universitari Vall d'Hebron)
Monforte-Pallarés, Arnau (Hospital Universitari Vall d'Hebron)
Bosch-Nicolau, Pau (Hospital Universitari Vall d'Hebron)
Augustin Recio, Salvador (Hospital Universitari Vall d'Hebron)
Sampol, Júlia (Hospital Universitari Vall d'Hebron)
Guillén-del-Castillo, Alfredo (Hospital Universitari Vall d'Hebron)
Almirante Gragera, Benito (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2024
Resum:	Background: Modulation of the immune system to prevent lung injury is being widely used against the new coronavirus disease (COVID-19) despite the scarcity of evidence. Methods: We report the preliminary results from the Vall d'Hebron prospective cohort study at Vall d'Hebron University Hospital, in Barcelona (Spain), including all consecutive patients who had a confirmed infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and who were treated with tocilizumab until March 25th. 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. 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. The median time from symptom onset to the first dose of tocilizumab was 9 (7-11) days. Mortality at 7 days was 26. 8%. Hazard ratio for mortality was 3. 3; 95% CI, 1. 3 to 8. 5 (age-adjusted hazard ratio for mortality 2. 1; 95% CI, 0. 8 to 5. 8) if tocilizumab was administered after the onset of ARDS. Conclusion: Time from lung injury onset to tocilizumab administration may be critical to patient recovery. Our preliminary data could inform bedside decisions until more data from clinical trials becomes available.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	Tocilizumab ; COVID19 ; IL6 ; SARS-CoV-2 ; Immonomodulation ; Viral pneumonia
Publicat a:	Medicina Clínica, Vol. 158, Núm. 11 (June 2024) , p. 509-518

DOI: 10.1016/j.medcle.2021.06.023
PMID: 35755602

Postprint 39 p, 1.1 MB

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