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The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study

OBJECTIVES: Evidence supports tocilizumab (TCZ) benefit and safety in adult patients with severe COVID-19. However, its effectiveness in critically ill older adult patients remains questionable. Thus, the study aimed to evaluate the safety and effectiveness of TCZ in older critically ill patients wi...

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Autores principales: Korayem, Ghazwa B., Aljuhani, Ohoud, Altebainawi, Ali F., Shaya, Abdulrahman I. Al, Alnajjar, Lina I., Alissa, Abdulrahman, Aldhaeefi, Mohammed, Kensara, Raed, Al Muqati, Hessa, Alhuwahmel, Abdulmohsen, Alhuthaili, Omar, Vishwakarma, Ramesh, Aldardeer, Namareq, Eljaaly, Khalid, Alharbi, Aisha, Harbi, Shmeylan Al, Katheri, Abdulmalik Al, Bekairy, Abdulkareem M. Al, Aljedai, Ahmed, Al Sulaiman, Khalid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9121644/
https://www.ncbi.nlm.nih.gov/pubmed/35605948
http://dx.doi.org/10.1016/j.ijid.2022.05.038
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author Korayem, Ghazwa B.
Aljuhani, Ohoud
Altebainawi, Ali F.
Shaya, Abdulrahman I. Al
Alnajjar, Lina I.
Alissa, Abdulrahman
Aldhaeefi, Mohammed
Kensara, Raed
Al Muqati, Hessa
Alhuwahmel, Abdulmohsen
Alhuthaili, Omar
Vishwakarma, Ramesh
Aldardeer, Namareq
Eljaaly, Khalid
Alharbi, Aisha
Harbi, Shmeylan Al
Katheri, Abdulmalik Al
Bekairy, Abdulkareem M. Al
Aljedai, Ahmed
Al Sulaiman, Khalid
author_facet Korayem, Ghazwa B.
Aljuhani, Ohoud
Altebainawi, Ali F.
Shaya, Abdulrahman I. Al
Alnajjar, Lina I.
Alissa, Abdulrahman
Aldhaeefi, Mohammed
Kensara, Raed
Al Muqati, Hessa
Alhuwahmel, Abdulmohsen
Alhuthaili, Omar
Vishwakarma, Ramesh
Aldardeer, Namareq
Eljaaly, Khalid
Alharbi, Aisha
Harbi, Shmeylan Al
Katheri, Abdulmalik Al
Bekairy, Abdulkareem M. Al
Aljedai, Ahmed
Al Sulaiman, Khalid
author_sort Korayem, Ghazwa B.
collection PubMed
description OBJECTIVES: Evidence supports tocilizumab (TCZ) benefit and safety in adult patients with severe COVID-19. However, its effectiveness in critically ill older adult patients remains questionable. Thus, the study aimed to evaluate the safety and effectiveness of TCZ in older critically ill patients with COVID-19. METHODS: A multicenter, retrospective study for all critically ill older adults (aged ≥65 years) with confirmed COVID-19 infection and admitted to the intensive care units (ICUs). Eligible patients were categorized into two groups based on TCZ use during ICU stay (control vs TCZ). Propensity score (PS) matching was used (1:1 ratio) based on the selected criteria. The primary outcome was the in-hospital mortality. RESULTS: A total of 368 critically ill older adult patients were included in the study. Fifty one patients (13.8%) received TCZ. The in-hospital mortality was lower in the TCZ group (HR 0.41; 95% CI 0.22–0.76, P-value = 0.005). Patients who received TCZ had lower odds of respiratory failure requiring mechanical ventilation (OR [95% CI]: 0.32 [0.10–0.98], P-value = 0.04). No statistically significant differences were found between the two groups for 30-days mortality, ventilator-free days, length of stay, and complications during ICU stay. CONCLUSION: Tocilizumab use in critically ill older adult patients with COVID-19 is associated with lower in-hospital mortality and a similar safety profile.
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spelling pubmed-91216442022-05-20 The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study Korayem, Ghazwa B. Aljuhani, Ohoud Altebainawi, Ali F. Shaya, Abdulrahman I. Al Alnajjar, Lina I. Alissa, Abdulrahman Aldhaeefi, Mohammed Kensara, Raed Al Muqati, Hessa Alhuwahmel, Abdulmohsen Alhuthaili, Omar Vishwakarma, Ramesh Aldardeer, Namareq Eljaaly, Khalid Alharbi, Aisha Harbi, Shmeylan Al Katheri, Abdulmalik Al Bekairy, Abdulkareem M. Al Aljedai, Ahmed Al Sulaiman, Khalid Int J Infect Dis Article OBJECTIVES: Evidence supports tocilizumab (TCZ) benefit and safety in adult patients with severe COVID-19. However, its effectiveness in critically ill older adult patients remains questionable. Thus, the study aimed to evaluate the safety and effectiveness of TCZ in older critically ill patients with COVID-19. METHODS: A multicenter, retrospective study for all critically ill older adults (aged ≥65 years) with confirmed COVID-19 infection and admitted to the intensive care units (ICUs). Eligible patients were categorized into two groups based on TCZ use during ICU stay (control vs TCZ). Propensity score (PS) matching was used (1:1 ratio) based on the selected criteria. The primary outcome was the in-hospital mortality. RESULTS: A total of 368 critically ill older adult patients were included in the study. Fifty one patients (13.8%) received TCZ. The in-hospital mortality was lower in the TCZ group (HR 0.41; 95% CI 0.22–0.76, P-value = 0.005). Patients who received TCZ had lower odds of respiratory failure requiring mechanical ventilation (OR [95% CI]: 0.32 [0.10–0.98], P-value = 0.04). No statistically significant differences were found between the two groups for 30-days mortality, ventilator-free days, length of stay, and complications during ICU stay. CONCLUSION: Tocilizumab use in critically ill older adult patients with COVID-19 is associated with lower in-hospital mortality and a similar safety profile. The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2022-09 2022-05-20 /pmc/articles/PMC9121644/ /pubmed/35605948 http://dx.doi.org/10.1016/j.ijid.2022.05.038 Text en © 2022 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Korayem, Ghazwa B.
Aljuhani, Ohoud
Altebainawi, Ali F.
Shaya, Abdulrahman I. Al
Alnajjar, Lina I.
Alissa, Abdulrahman
Aldhaeefi, Mohammed
Kensara, Raed
Al Muqati, Hessa
Alhuwahmel, Abdulmohsen
Alhuthaili, Omar
Vishwakarma, Ramesh
Aldardeer, Namareq
Eljaaly, Khalid
Alharbi, Aisha
Harbi, Shmeylan Al
Katheri, Abdulmalik Al
Bekairy, Abdulkareem M. Al
Aljedai, Ahmed
Al Sulaiman, Khalid
The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study
title The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study
title_full The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study
title_fullStr The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study
title_full_unstemmed The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study
title_short The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study
title_sort safety and effectiveness of tocilizumab in older adult critically ill patients with covid-19: a multicenter, cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9121644/
https://www.ncbi.nlm.nih.gov/pubmed/35605948
http://dx.doi.org/10.1016/j.ijid.2022.05.038
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