| Journal: | Revista de investigación clínica |
| Database: | PERIÓDICA |
| System number: | 000452986 |
| ISSN: | 0034-8376 |
| Authors: | Martínez Guerra, Bernardo A1 de León Cividanes, Nereyda A1 Tamez Torres, Karla M2 Román Montes, Carla M1 Rajme López, Sandra1 Ortiz Brizuela, Edgar1 Aguilar Salinas, Carlos A3 Sierra Madero, Juan1 Sifuentes Osornio, José4 Ponce de León, Alfredo1 González Lara, María F2 |
| Institutions: | 1Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Enfermedades Infecciosas, Ciudad de México. México 2Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Laboratorio de Microbiología Clínica, Ciudad de México. México 3Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Nutrición, Ciudad de México. México 4Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Medicina, Ciudad de México. México |
| Year: | 2022 |
| Season: | Ene-Feb |
| Volumen: | 74 |
| Number: | 1 |
| Pages: | 40-50 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico, descriptivo |
| English abstract | Trials evaluating safety and efficacy of tocilizumab in coronavirus disease 19 (COVID-19) show contradictory results. Objective: The objective of the study was to evaluate the effect of tocilizumab in hospital mortality among patients with severe COVID-19 in a third-level medical center. Methods: This prospective cohort study included patients with severe and critical COVID-19. Primary outcome was death during hospitalization. Secondary outcomes included invasive mechanical ventilation (IMV), days on IMV, ventilator-free days (VFDs), length of hospital stay (LOS), and development of hospital-acquired infections (HAIs). Bivariate, multivariate, and propensity score matching analysis were performed. Results: During the study period, 99/794 (12%) patients received tocilizumab. Male patients, health care workers, and patients with increased inflammatory markers received tocilizumab more frequently. No difference in hospital mortality was observed between groups (34% vs. 34%, p = 0.98). Tocilizumab was not independently associated with mortality. No significant treatment effects were observed in propensity score analysis. IMV was more frequent (46% vs. 11%, p < 0.01) and LOS was longer (12 vs. 7 days, p < 0.01) in the tocilizumab group, reflecting increased severity. Although HAIs were more frequent in the tocilizumab group (22% vs. 10%, p < 0.01), no difference was seen after adjusting for IMV (38% vs. 40%, p = 0.86). Conclusions: In our study, tocilizumab was not associated with decreased hospital mortality among patients with severe COVID-19 |
| Disciplines: | Medicina |
| Keyword: | Farmacología, COVID-19, SARS-CoV-2, Tocilizumab, Mortalidad |
| Keyword: | Pharmacology, Tocilizumab, COVID-19, SARS-CoV-2, Mortality |
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