Bernardo A Martínez-Guerra, Nereyda A de-León-Cividanes, Karla M Tamez-Torres, Carla M Román-Montes, Sandra Rajme-López, Edgar Ortiz-Brizuela, Carlos A Aguilar-Salinas, Juan Sierra-Madero, José Sifuentes-Osornio, Alfredo Ponce-de-León, María F González-Lara
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Secondary outcomes included invasive mechanical ventilation (IMV), days on IMV, ventilator-free days (VFDs), length of hospital stay (LOS), and development of hospitalacquired infections (HAIs). Bivariate, multivariate, and propensity score matching analysis were performed.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>In our study, tocilizumab was not associated with decreased hospital mortality among patients with severe COVID-19.</p>","PeriodicalId":49612,"journal":{"name":"Revista De Investigacion Clinica-Clinical and Translational Investigation","volume":"74 1","pages":"40-50"},"PeriodicalIF":1.4000,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Effect of Tocilizumab in Mortality among Patients with Severe and Critical Covid-19: Experience in a Third-Level Medical Center.\",\"authors\":\"Bernardo A Martínez-Guerra, Nereyda A de-León-Cividanes, Karla M Tamez-Torres, Carla M Román-Montes, Sandra Rajme-López, Edgar Ortiz-Brizuela, Carlos A Aguilar-Salinas, Juan Sierra-Madero, José Sifuentes-Osornio, Alfredo Ponce-de-León, María F González-Lara\",\"doi\":\"10.24875/RIC.21000404\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Trials evaluating safety and efficacy of tocilizumab in coronavirus disease 19 (COVID-19) show contradictory results.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>This prospective cohort study included patients with severe and critical COVID-19. 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引用次数: 2
摘要
背景:评估托珠单抗治疗冠状病毒病19 (COVID-19)的安全性和有效性的试验结果相互矛盾。目的:本研究的目的是评估托珠单抗对三级医疗中心重症COVID-19患者住院死亡率的影响。方法:本前瞻性队列研究纳入重症和危重型COVID-19患者。主要结局为住院期间死亡。次要结局包括有创机械通气(IMV)、使用IMV天数、无呼吸机天数(vfd)、住院时间(LOS)和院内获得性感染(HAIs)的发生。进行了双变量、多变量和倾向评分匹配分析。结果:在研究期间，99/794(12%)患者接受了tocilizumab治疗。男性患者、卫生保健工作者和炎症标志物升高的患者更频繁地接受托珠单抗治疗。两组住院死亡率无差异(34% vs. 34%， p = 0.98)。托珠单抗与死亡率无独立相关性。倾向评分分析未观察到显著的治疗效果。托珠单抗组IMV更频繁(46% vs. 11%， p < 0.01)， LOS更长(12 vs. 7天，p < 0.01)，反映了严重程度的增加。虽然HAIs在tocilizumab组更常见(22% vs. 10%， p < 0.01)，但在调整IMV后没有发现差异(38% vs. 40%， p = 0.86)。结论:在我们的研究中，托珠单抗与重症COVID-19患者住院死亡率的降低无关。
Effect of Tocilizumab in Mortality among Patients with Severe and Critical Covid-19: Experience in a Third-Level Medical Center.
Background: 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 hospitalacquired 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.
期刊介绍：
The Revista de Investigación Clínica – Clinical and Translational Investigation (RIC-C&TI), publishes original clinical and biomedical research of interest to physicians in internal medicine, surgery, and any of their specialties. The Revista de Investigación Clínica – Clinical and Translational Investigation is the official journal of the National Institutes of Health of Mexico, which comprises a group of Institutes and High Specialty Hospitals belonging to the Ministery of Health. The journal is published both on-line and in printed version, appears bimonthly and publishes peer-reviewed original research articles as well as brief and in-depth reviews. All articles published are open access and can be immediately and permanently free for everyone to read and download. The journal accepts clinical and molecular research articles, short reports and reviews.
Types of manuscripts:
– Brief Communications
– Research Letters
– Original Articles
– Brief Reviews
– In-depth Reviews
– Perspectives
– Letters to the Editor
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