Effect of Tocilizumab in Mortality among Patients with Severe and Critical Covid-19: Experience in a Third-Level Medical Center



Título del documento: Effect of Tocilizumab in Mortality among Patients with Severe and Critical Covid-19: Experience in a Third-Level Medical Center
Revista: Revista de investigación clínica
Base de datos: PERIÓDICA
Número de sistema: 000452986
ISSN: 0034-8376
Autores: 1
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Instituciones: 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
Año:
Periodo: Ene-Feb
Volumen: 74
Número: 1
Paginación: 40-50
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés 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
Disciplinas: Medicina
Palabras clave: Farmacología,
COVID-19,
SARS-CoV-2,
Tocilizumab,
Mortalidad
Keyword: Pharmacology,
Tocilizumab,
COVID-19,
SARS-CoV-2,
Mortality
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