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Tocilizumab in ICU-admitted COVID-19 Patients: A Retrospective Study

BACKGROUND: Severe and critically-ill COVID-19 patients are characterized by a severe inflammatory response. Pharmacologic inhibition of acute-phase inflammatory pathways such as IL-6 receptor inhibitor, Tocilizumab (TCZ) may improve patient outcomes in these cases. Consequently, the therapeutic ben...

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Autores principales: Siami, Zeinab, Hedayat Yaghoobi, Mojtaba, Karimi, Parsa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Iran University of Medical Sciences 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657263/
https://www.ncbi.nlm.nih.gov/pubmed/38021396
http://dx.doi.org/10.47176/mjiri.37.92
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author Siami, Zeinab
Hedayat Yaghoobi, Mojtaba
Karimi, Parsa
author_facet Siami, Zeinab
Hedayat Yaghoobi, Mojtaba
Karimi, Parsa
author_sort Siami, Zeinab
collection PubMed
description BACKGROUND: Severe and critically-ill COVID-19 patients are characterized by a severe inflammatory response. Pharmacologic inhibition of acute-phase inflammatory pathways such as IL-6 receptor inhibitor, Tocilizumab (TCZ) may improve patient outcomes in these cases. Consequently, the therapeutic benefit of TCZ was evaluated in this study. METHODS: We evaluated intravenous tocilizumab in severe and critically ill adult COVID-19 patients who met pre-defined stringent CRS criteria. A single-center, prospective, observational cohort study was carried out among consecutive adult (≥18 years of age) in-patients with COVID-19 between March 20, 2020 and March 20, 2021. In total, 354 patients were included in our study. Mortality and time to hospital discharge were compared between patients who received tocilizumab treatment (n = 177) and those who did not (n = 177). RESULTS: A total of 354 patients were analyzed whereas 177 patients were included in each group. In those receiving TCZ, all-cause mortality was significantly reduced, corresponding to an adjusted hazard ratio (HR) of 0.57, (95% confidence interval (CI): 0.43-0.76; P < 0.001). Furthermore, time to discharge was significantly improved in the TCZ group (HR: 1.66; 95%CI: 1.17-2.36, P = 0.004). Invasive mechanical ventilation was not statistically different among the study groups after adjusting for confounding variables (HR: 1.38; 95%CI: 0.89-2.14; P = 0.139). Dosing frequency was independent of survival status (P = 0.676). CONCLUSION: The use of TCZ in ICU-hospitalized patients resulted in improved patient survival and reduced duration of hospitalization. Further studies are needed to confirm the efficacy of TCZ in severe and critical COVID-19 cases.
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spelling pubmed-106572632023-08-28 Tocilizumab in ICU-admitted COVID-19 Patients: A Retrospective Study Siami, Zeinab Hedayat Yaghoobi, Mojtaba Karimi, Parsa Med J Islam Repub Iran Original Article BACKGROUND: Severe and critically-ill COVID-19 patients are characterized by a severe inflammatory response. Pharmacologic inhibition of acute-phase inflammatory pathways such as IL-6 receptor inhibitor, Tocilizumab (TCZ) may improve patient outcomes in these cases. Consequently, the therapeutic benefit of TCZ was evaluated in this study. METHODS: We evaluated intravenous tocilizumab in severe and critically ill adult COVID-19 patients who met pre-defined stringent CRS criteria. A single-center, prospective, observational cohort study was carried out among consecutive adult (≥18 years of age) in-patients with COVID-19 between March 20, 2020 and March 20, 2021. In total, 354 patients were included in our study. Mortality and time to hospital discharge were compared between patients who received tocilizumab treatment (n = 177) and those who did not (n = 177). RESULTS: A total of 354 patients were analyzed whereas 177 patients were included in each group. In those receiving TCZ, all-cause mortality was significantly reduced, corresponding to an adjusted hazard ratio (HR) of 0.57, (95% confidence interval (CI): 0.43-0.76; P < 0.001). Furthermore, time to discharge was significantly improved in the TCZ group (HR: 1.66; 95%CI: 1.17-2.36, P = 0.004). Invasive mechanical ventilation was not statistically different among the study groups after adjusting for confounding variables (HR: 1.38; 95%CI: 0.89-2.14; P = 0.139). Dosing frequency was independent of survival status (P = 0.676). CONCLUSION: The use of TCZ in ICU-hospitalized patients resulted in improved patient survival and reduced duration of hospitalization. Further studies are needed to confirm the efficacy of TCZ in severe and critical COVID-19 cases. Iran University of Medical Sciences 2023-08-28 /pmc/articles/PMC10657263/ /pubmed/38021396 http://dx.doi.org/10.47176/mjiri.37.92 Text en © 2023 Iran University of Medical Sciences https://creativecommons.org/licenses/by-nc-sa/1.0/This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial-ShareAlike 1.0 License (CC BY-NC-SA 1.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.
spellingShingle Original Article
Siami, Zeinab
Hedayat Yaghoobi, Mojtaba
Karimi, Parsa
Tocilizumab in ICU-admitted COVID-19 Patients: A Retrospective Study
title Tocilizumab in ICU-admitted COVID-19 Patients: A Retrospective Study
title_full Tocilizumab in ICU-admitted COVID-19 Patients: A Retrospective Study
title_fullStr Tocilizumab in ICU-admitted COVID-19 Patients: A Retrospective Study
title_full_unstemmed Tocilizumab in ICU-admitted COVID-19 Patients: A Retrospective Study
title_short Tocilizumab in ICU-admitted COVID-19 Patients: A Retrospective Study
title_sort tocilizumab in icu-admitted covid-19 patients: a retrospective study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657263/
https://www.ncbi.nlm.nih.gov/pubmed/38021396
http://dx.doi.org/10.47176/mjiri.37.92
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