Respiratory investigation最新文献

{"title":"A systematic review of factors associated with poor prognosis despite appropriate antibiotics usage for pneumonia","authors":"Akihiko Goto ,&nbsp;Kentaro Ishikawa ,&nbsp;Kosaku Komiya","doi":"10.1016/j.resinv.2024.10.012","DOIUrl":"10.1016/j.resinv.2024.10.012","url":null,"abstract":"<div><div>Treatment with appropriate antibiotics does not seem to be associated with prognosis among elderly patients with pneumonia. Identifying factors associated with poor prognosis despite the use of appropriate antibiotics might help withhold aggressive antibiotic treatment in patients with pneumonia. This systematic review aims to identify the risk factors associated with unfavored outcomes despite using appropriate antibiotics for pneumonia. The PubMed database was searched for studies focusing on appropriate antibiotic use in patients with pneumonia (assessed on Aug 7, 2024). Appropriate antibiotics were defined as those sensitive to microorganisms isolated from patients. The risk of bias was evaluated using the Risk of Bias Assessment tool for nonrandomized Studies utilized for controlled observational studies.</div><div>A total of 1563 studies were identified from the database, and eight observational studies were included in this review: ventilator-associated pneumonia (n = 4), community-onset pneumonia (n = 2), <em>P. aeruginosa</em> pneumonia (n = 1), and <em>S. maltophilia</em> pneumonia (n = 1). Advanced age was the most commonly evaluated factor associated with mortality. Additionally, high severity scores were related to the unfavored outcomes even after treatment with appropriate antibiotics. Advanced age and high severity scores may be associated with increased mortality despite appropriate antibiotic usage for pneumonia. Broad-spectrum antibiotics might not be indicated in elderly pneumonia patients with high severity status who do not wish to receive aggressive antibiotic treatments.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1215-1219"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary investigation of the significance of cavitary lesions in recurrent hemoptysis following bronchial artery embolization for nontuberculous mycobacterial pulmonary disease","authors":"Hiroto Hatano,&nbsp;Manabu Suzuki,&nbsp;Mio Sugino,&nbsp;Mikako Nakamura,&nbsp;Yusaku Kusaba,&nbsp;Yoshie Tsujimoto,&nbsp;Akane Ishida,&nbsp;Masao Hashimoto,&nbsp;Eriko Morino,&nbsp;Jin Takasaki,&nbsp;Naoki Nishimura,&nbsp;Hiroshi Nokihara,&nbsp;Shinyu Izumi,&nbsp;Masayuki Hojo","doi":"10.1016/j.resinv.2024.11.001","DOIUrl":"10.1016/j.resinv.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Nontuberculous mycobacterial pulmonary disease (NTM-PD) varies widely in clinical presentation, and some patients experience hemoptysis. Bronchial artery embolization (BAE) is a treatment option for hemoptysis caused by NTM-PD. However, the association between post-BAE rebleeding risk and the presence of cavitary lesions has not been fully elucidated.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted on patients with NTM-PD who had undergone BAE at our institution. Patients were classified into Cavitary and Non-cavitary groups, and baseline characteristics and clinical outcomes were compared.</div></div><div><h3>Results</h3><div>Among the 155 BAE cases between 2013 and 2023, 18 were included in the analysis, and four experienced rebleeding. The Cavitary group tended to have a higher rebleeding rate 24 months after BAE (37.5% vs. 10.0%, p = 0.27). Furthermore, the Cavitary group showed a significantly higher number of non-bronchial arteries involved (median number: 1.5 vs. 0.0, p = 0.02), a higher proportion of patients with a prior antibiotic treatment history (100% vs. 20%, p = 0.001), and longer duration from diagnosis to BAE (median year: 9.0 vs. 0.6, p = 0.02). The Kaplan-Meier curves showed a tendency for shorter rebleeding-free survival in the Cavitary group (p = 0.10).</div></div><div><h3>Conclusions</h3><div>Cavitary lesions in patients with NTM-PD may predict higher rebleeding rates after BAE. Further research with larger cohorts is needed to better understand rebleeding risk factors in BAE for NTM-PD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1227-1232"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of constipation with the survival of patients with idiopathic interstitial pneumonias","authors":"Sho Takuma ,&nbsp;Kazutaka Mori ,&nbsp;Masato Karayama ,&nbsp;Yusuke Inoue ,&nbsp;Hideki Yasui ,&nbsp;Hironao Hozumi ,&nbsp;Yuzo Suzuki ,&nbsp;Kazuki Furuhashi ,&nbsp;Tomoyuki Fujisawa ,&nbsp;Noriyuki Enomoto ,&nbsp;Naoki Inui ,&nbsp;Takafumi Suda","doi":"10.1016/j.resinv.2024.10.010","DOIUrl":"10.1016/j.resinv.2024.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Constipation is associated with the prognosis of several chronic diseases. However, the effect of constipation on the prognosis of idiopathic interstitial pneumonias (IIPs) remains unclear. This study aimed to investigate the association between constipation and the prognosis of patients with IIPs.</div></div><div><h3>Methods</h3><div>In this single-center, observational study, the association between constipation and survival of patients with IIPs was retrospectively investigated using a marginal structural model (MSM) analysis with weighting of age, sex, body mass index, treatment (corticosteroids, immunosuppressants, and antifibrotic agents), and pulmonary function (percent predicted forced vital capacity and diffusing capacity of the lungs for carbon monoxide).</div></div><div><h3>Results</h3><div>A total of 433 patients with IIPs (148 and 285 patients with idiopathic pulmonary fibrosis [IPF] and those without IPF) were included in the study. During the observation period, 238 patients developed constipation. The MSM analysis showed that constipation was significantly associated with shorter overall survival (hazard ratio [HR], 2.374; 95% confidence interval, 1.924–2.928, <em>p</em> &lt; 0.001). When the use of antifibrotic agents was weighted separately as nintedanib or pirfenidone, constipation was significantly associated with shorter survival (HR, 2.427; 95% CI, 1.972–2.988, <em>p</em> &lt; 0.001; and HR, 2.395; 95% CI, 1.940–2.957, <em>p</em> &lt; 0.001, respectively). Furthermore, a subgroup analysis showed that constipation was associated with worse survival in patients with IPF and in those without IPF, regardless of the disease severity.</div></div><div><h3>Conclusions</h3><div>This study shows that constipation is an independent prognostic factor for patients with IIPs, suggesting its potential clinical utility.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1204-1208"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine for long-term continuous positive airway pressure therapy: A six-month follow-up study in Japan using propensity score matching","authors":"Toshiki Akahoshi ,&nbsp;Daisuke Endo ,&nbsp;Kenichi Nagaoka ,&nbsp;Ayako Hori ,&nbsp;Tatsuya Ito ,&nbsp;Akihito Uematsu ,&nbsp;Yutaka Kozu ,&nbsp;Yasuhiro Gon ,&nbsp;Kazuo Chin ,&nbsp;Ryuji Furihata","doi":"10.1016/j.resinv.2024.11.002","DOIUrl":"10.1016/j.resinv.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>During the coronavirus disease (COVID-19) pandemic, Japan's health insurance system allowed continuous positive airway pressure (CPAP) telephone consultations to extend clinic visit intervals. This study aimed to determine whether 6-month CPAP adherence in the telemedicine (TM) group was inferior to that in the standard care group.</div></div><div><h3>Methods</h3><div>Patients receiving long-term CPAP therapy for at least 6 months for obstructive sleep apnea (OSA) from two clinics in Japan were recruited between May and July 2020. The TM group consisted of patients who had not visited the clinic in person for 6 months, with physicians providing telephone consultations every 1–2 months. The standard care group included patients who visited the clinic monthly for physician consultation. In both groups, physicians reviewed CPAP usage data via telemonitoring. Patients were classified into three groups according to change in adherence: ≤ −5%, &gt; −5 to &lt;5%, and ≥5%. The primary outcome was the number of patients with worsened CPAP adherence (≤−5%).</div></div><div><h3>Results</h3><div>Of the 479 patients in the TM group and 146 in the standard care group, 120 were matched using propensity score 1:1 nearest neighbor matching and selected from both groups. Adherence worsened in 41 (34.2%) and 32 (26.7 %) patients in the TM and standard care groups, respectively. The TM group was not inferior to the standard care group in terms of the proportion of patients with worsened CPAP adherence (χ² = 1.81, df = 1, <em>P</em> = 0.178).</div></div><div><h3>Conclusions</h3><div>This study found no significant difference in the 6-month CPAP adherence between the TM and standard care groups.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1233-1238"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A protocol for a Japanese prospective cohort evaluating the features of patients with uncontrolled asthma achieving clinical remission: J-CIRCLE","authors":"Naoya Tanabe ,&nbsp;Yu Hara ,&nbsp;Kaoruko Shimizu ,&nbsp;Satoshi Marumo ,&nbsp;Jun Miyata ,&nbsp;Kyohei Morita ,&nbsp;Tetsuya Watanabe ,&nbsp;Keiji Oishi ,&nbsp;Masafumi Yamaguchi ,&nbsp;Kazuhisa Asai ,&nbsp;Yasutaka Nakano ,&nbsp;Tsunahiko Hirano ,&nbsp;Kazuto Matsunaga ,&nbsp;Toshiyuki Koya ,&nbsp;Hisako Matsumoto ,&nbsp;Koichi Fukunaga ,&nbsp;Satoshi Konno ,&nbsp;Takeshi Kaneko ,&nbsp;Toyohiro Hirai","doi":"10.1016/j.resinv.2024.10.009","DOIUrl":"10.1016/j.resinv.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Increasing expectations that biologics can be used as disease-modifying agents have introduced the concept of clinical remission (CR) in managements of severe asthma. Given the clinical relevance of computed tomography (CT) and blood biomarkers, we hypothesized that further refinement of CR criteria as well as incorporation of CT and blood biomarkers as indicators for structural and biological remission (SR, BR) would enable predicting long-term disease stability in patients with severe asthma treated with biologics.</div></div><div><h3>Methods</h3><div>This Japanese multicenter prospective observational cohort will enroll patients with severe asthma who will start a new biologic (including a change from another biologic). The enrolled patients will be longitudinally followed up for 3 years. At enrollment, patients will undergo postbronchodilator spirometry, blood tests, fractional exhaled nitric oxide, chest and sinus CT, and patient-reported outcome questionnaires. Follow-up examinations will be performed at 1, 3, 6, 12, 24, and 36 months. The rates of CR resulting from different criteria after 1 year of treatment with biologics will be compared, and factors associated with long-term disease stability after 3 years of biologic treatments will be identified.</div></div><div><h3>Discussion</h3><div>This multicenter study in Japan will provide data that will help establish more appropriate criteria for CR, structural remission, and biological remission to predict long-term disease stability in patients with severe asthma who receive biologic therapy.</div></div><div><h3>Ethics and dissemination</h3><div>The study was approved by the Ethics Committee of Kyoto University (No. R4419, approval date June 11th, 2024).</div></div><div><h3>Trial registration</h3><div>The University Hospital Medical Information Network (UMIN000053771).</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1209-1214"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of vaccines against respiratory infections in adults","authors":"Koji Kuronuma","doi":"10.1016/j.resinv.2024.09.006","DOIUrl":"10.1016/j.resinv.2024.09.006","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1202-1203"},"PeriodicalIF":2.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory bilateral chylothorax and chylous ascites in a patient with systemic lupus erythematosus treated by pleuro-peritoneal and peritoneal-venous shunts along with cell-free and concentrated ascites re-infusion therapy","authors":"Yuki Kuwahara ,&nbsp;Hiroki Tashiro ,&nbsp;Go Takeshita ,&nbsp;Yoshiaki Egashira ,&nbsp;Akihito Maruyama ,&nbsp;Yuki Ikeda ,&nbsp;Shinya Kimura ,&nbsp;Naoko Sueoka-Aragane ,&nbsp;Koichiro Takahashi","doi":"10.1016/j.resinv.2024.10.006","DOIUrl":"10.1016/j.resinv.2024.10.006","url":null,"abstract":"<div><div>A pleural effusion is a common pulmonary manifestation of systemic lupus erythematosus (SLE), and differential diagnosis is needed to perform targeted treatments. An SLE patient with refractory chylothorax is presented. Chylothorax rarely occurs in SLE patients and occasionally follows a refractory clinical course despite intensive treatment with immunosuppressive therapies, resulting in a poor prognosis with malnutrition caused by frequent thoracenteses. In such cases, pleuro-peritoneal and peritoneal-venous shunts along with cell-free and concentrated ascites re-infusion therapy might be effective to improve the dyspnea while maintaining nutrition.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1191-1194"},"PeriodicalIF":2.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of lower dose sulfamethoxazole/trimethoprim for Pneumocystis jirovecii pneumonia prophylaxis in patients with systemic rheumatic diseases receiving moderate-to high-dose glucocorticoids","authors":"Shin-ichiro Ohmura ,&nbsp;Takayuki Masui ,&nbsp;Toshitaka Yukishima ,&nbsp;Yusuke Ohkubo ,&nbsp;Haruka Yonezawa ,&nbsp;Toshiaki Miyamoto","doi":"10.1016/j.resinv.2024.10.007","DOIUrl":"10.1016/j.resinv.2024.10.007","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the effectiveness and safety of low-dose sulfamethoxazole/trimethoprim (SMX/TMP) for <em>Pneumocystis jirovecii</em> pneumonia (PCP) prophylaxis in patients with systemic rheumatic disease (SRD) who were receiving glucocorticoids.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data obtained from Japanese patients with SRD who received glucocorticoids between January 2006 and April 2024. Patients were divided into two groups based on the initial dose of SMX/TMP: low-dose (one tablet twice weekly on non-consecutive days); conventional-dose (one tablet per day). The primary endpoint was the incidence of PCP after 1 year since the initiation of SMX/TMP. Secondary endpoints were discontinuation rates of SMX/TMP therapy and severe adverse drug reactions (ADRs) after 1 year since the initiation of SMX/TMP in both groups, before and after adjusting for patient characteristics.</div></div><div><h3>Results</h3><div>A total of 186 patients were included in this study: 60 in the low-dose group and 126 in the conventional-dose group. No patients developed PCP within one year after starting SMX/TMP; however, two patients in the low-dose group required escalation of the SMX/TMP dose to the conventional dose due to subclinical PCP. In the adjusted analysis, the low-dose group had a significantly lower discontinuation rate and a lower incidence rate of severe ADRs than the conventional-dose group.</div></div><div><h3>Conclusions</h3><div>Lower-dose SMX/TMP therapy was as effective as conventional therapy for PCP prophylaxis and was associated with lower discontinuation rates in patients with SRD receiving glucocorticoids.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1195-1201"},"PeriodicalIF":2.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung cancer with comorbid interstitial pneumonia: Current situation and animal model development","authors":"Taku Nakashima","doi":"10.1016/j.resinv.2024.10.008","DOIUrl":"10.1016/j.resinv.2024.10.008","url":null,"abstract":"<div><div>Interstitial pneumonia includes a range of disorders affecting the lung interstitium, significantly impacting life expectancy, especially during acute exacerbations. Concurrently, lung cancer remains a leading cause of cancer-related deaths worldwide. The coexistence of these two conditions presents a formidable challenge, complicating diagnosis, treatment, and prognosis. This review explores the critical issues associated with lung cancer comorbid with interstitial pneumonia, focusing on diagnostic challenges, prognosis, treatment complications, and the lack of effective research tools. Diagnosing lung cancer in patients with interstitial pneumonia is complicated due to overlapping imaging features and the risks associated with biopsies. The prognosis is poorer for patients with both conditions, as interstitial pneumonia promotes a more aggressive lung cancer phenotype. Standard treatment for interstitial pneumonia can inadvertently facilitate lung cancer progression, while anticancer therapies often exacerbate interstitial pneumonia. To address the lack of appropriate research tools, a novel murine model combining orthotopic lung cancer cell transplantation with bleomycin-induced interstitial pneumonia was developed to better understand their interaction. This new murine model successfully mimics the human condition, demonstrating increased tumor growth, metastasis, and alterations in the tumor microenvironment, including elevated tumor-associated macrophages, cancer-associated myofibroblasts, and regulatory T cells, alongside decreased cytotoxic T lymphocytes. Lung cancer comorbid with interstitial pneumonia represents a severe clinical challenge due to diagnostic difficulties and treatment-related complications. The novel murine model offers a valuable tool for future research to develop effective therapies. Dedicated efforts are needed to address this complex pathophysiology to improve patient outcomes.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1183-1190"},"PeriodicalIF":2.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of oxygen saturation/fraction of inspired oxygen 3 days after initiation of tocilizumab treatment in patients with COVID-19","authors":"Yusuke Kurosawa ,&nbsp;Yutaka Kozu ,&nbsp;Kaori Soda ,&nbsp;Yasunori Itoda ,&nbsp;Yusuke Jinno ,&nbsp;Shun Yokota ,&nbsp;Mamiko Hoshi ,&nbsp;Tsukasa Nishizawa ,&nbsp;Hisato Hiranuma ,&nbsp;Kenji Mizumura ,&nbsp;Tetsuo Shimizu ,&nbsp;Tadateru Takayama ,&nbsp;Kazuo Chin ,&nbsp;Yasuhiro Gon","doi":"10.1016/j.resinv.2024.10.005","DOIUrl":"10.1016/j.resinv.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Tocilizumab is effective in treating severe coronavirus disease 2019 (COVID-19). However, the specific time point it acts as a valid indicator of treatment efficacy remains unclear. This study aimed to determine the optimal day for assessing the prognostic value of the oxygen saturation/fraction of inspired oxygen (SpO₂/FiO₂) and ratio of respiratory rate-oxygenation (ROX) index in patients receiving tocilizumab for COVID-19.</div></div><div><h3>Methods</h3><div>All patients admitted to our hospital from March 2020 to July 2021 who received tocilizumab for COVID-19 were retrospectively identified from hospital charts. Biodata, medical history, and laboratory tests results were obtained from medical records. The prognostic values of the SpO₂/FiO₂ and ROX index for predicting mortality were assessed. Cox proportional hazard and receiver operating characteristic curve models were utilized.</div></div><div><h3>Results</h3><div>Of the 84 included patients, 34 died within 7 days after discharge. The patients who recovered had a mean age of 65 years and were younger than those who died. The multivariate analysis indicated that multiple comorbidities, cancer history, CURB-65 score, neutrophil and lymphocyte counts, neutrophil/lymphocyte ratio, and lactate dehydrogenase levels were higher in those who died compared with those who survived. No significant differences were found in dyspnea or total bilirubin levels between the two groups. The SpO₂/FiO₂ at 3 days post-tocilizumab initiation was strongly associated with survival.</div></div><div><h3>Conclusions</h3><div>The SpO₂/FiO₂ on day 3 post-tocilizumab initiation was a predictor of COVID-19 prognosis, which could be employed in determining clinical decisions. Prompt alternative interventions should be considered when this ratio does not improve.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1176-1182"},"PeriodicalIF":2.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}