评估Tocilizumab在SARS-CoV-2相关细胞因子风暴中的治疗反应:单中心经验

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引用次数: 0

摘要

背景:COVID-19危重患者可能出现细胞因子风暴样现象。IL-6被发现是这种细胞因子风暴的关键参与者,COVID-19的严重程度与IL-6水平直接相关。目的:评价托珠单抗在COVID-19患者炎症期的疗效。方法:本横断面研究基于对拉合尔法鲁克医院COVID病房从2020年10月1日至2020年12月30日收治的共17名COVID患者记录的数据进行回顾性收集。拉合尔Akhtar Saeed医学和牙科学院的伦理审查委员会批准了这项研究。所有患者均静脉注射8mg/kg体重Tocilizumab治疗COVID-19患者肺炎。所有患者在输注托珠单抗的第3天和第7天之前和之后的最初2-3天(24-48小时)评估血清IL-6水平。采用电化学发光免疫分析法定量血清IL-6。采用SPSS (v. 22.0)软件进行分析。结果:分析显示,阿克坦拉治疗前、给药后3天和给药后7天的IL-6中位(IQR)水平分别为1879 (IQR=726-2842)、1136 (IQR=499-2266)和438 (IQR=151-1085)。Actemra给药前后Il-6水平变化有统计学意义(p=0.001)。服用Actemra 3天和7天后IL-6水平也有显著差异(p=0.04)。存活和死亡患者在actemra治疗后第7天IL-6水平的中位数差异有统计学意义(P=0.01)。结论:托珠单抗配合序贯实验室检查,特别是il - 6可能有助于减少严重COVID-19肺炎患者细胞因子风暴的并发症,从而获得更好的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of therapeutic response of the Tocilizumab in SARS-CoV-2 associated cytokine storm: A single center experience
Background: Critical COVID-19 patients may present with a cytokine storm-like phenomenon. IL-6 is found to be a key player in this cytokine storm, and COVID-19 severity is directly linked to the IL-6 levels. Objective: To assess the response of Tocilizumab during the inflammatory phase of COVID-19 patients. Methodology: This cross-sectional study was based on a retrospective collection of data from the records of a total of 17 COVID patients, admitted to the COVID Unit of Farooq Hospital, Lahore, from 1st October 2020 to 30th December 2020. The ethical review board of Akhtar Saeed Medical and Dental College, Lahore approved the research. All these patients received 8mg/kg of body weight Tocilizumab intravenously for pneumonia in COVID-19 patients. All these patients were evaluated for IL-6 levels in serum initially for 2-3 days (24-48 hours) before and after the 3rd day and 7th day of Tocilizumab infusion. The Electrochemiluminescence immunoassay method was used to quantify serum IL-6. The SPSS (v. 22.0) was used for analysis. Results: The analysis shows that the median (IQR) IL-6 levels prior to treatment with Actemra, three days after Actemra administration, and seven days after Actemra was administered, were 1879 (IQR=726-2842), 1136 (IQR=499-2266), and 438 (IQR=151-1085), respectively. The change in Il-6 levels before and after Actemra administration was statistically significant, (p=0.001). A notable difference was also observed between IL-6 levels with respect to Actemra administration after three and seven days (p=0.04). There was a statistically significant median difference in IL-6 levels seven days post-Actemra in patients who survived and died, (P=0.01). Conclusion: Tocilizumab administration along with sequential laboratory investigations particularly IL6 might be helpful in reducing the complications of cytokine storm in patients with severe COVID-19 pneumonia, resulting in better outcomes.
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