M. Rubio-Rivas, M. Ronda, A. Padullés, F. Mitjavila, A. Riera-Mestre, C. García-Forero, A. Iriarte, J. M. Mora, N. Padullés, M. González, X. Solanich, M. Gasa, G. Suarez-Cuartin, J. Sabater, X. Perez-Fernandez, E. Santacana, E. Leiva, A. Ariza-Solé, P. Dallaglio, M. Quero, A. Soriano, A. Pasqualetto, M. Koo, V. Estève, A. Antolí, Rafael Moreno-González, S. Yun, P. Cerdà, M. Llaberia, F. Formiga, M. Fanlo, A. Montero, D. Chivite, O. Capdevila, F. Bolao, X. Pintó, J. Llop, A. Sabaté, J. Guardiola, J. Cruzado, J. Comín-Colet, S. Santos, R. Jódar, X. Corbella
International Journal of Infectious Diseases, 2020
Objectives To assess the characteristics and risk factors for mortality in patients with severe COVID-19 treated with tocilizumab (TCZ), alone or in combination with corticosteroids (CS). Methods 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. Results A total of 1,092 COVID-19 patients 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, 155 (83.3 %) patients were receiving non-invasive 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 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. Conclusions In severe COVID-19 patients receiving TCZ due to systemic host-immune inflammatory response syndrome, the use of CS in addition to TCZ therapy, showed beneficial effect in preventing in-hospital mortality.
Cited by 12 publications.
Field of study: Medicine