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Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France

We aimed to assess the factors associated with mortality in patients treated with tocilizumab for a SARS-CoV-2 pneumonia due to the delta or omicron variants of concern (VOC) and detect an effect of tocilizumab on mortality. We conducted a prospective cohort study in a tertiary hospital from 1 Augus...

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Autores principales: Laffont-Lozes, Paul, Laureillard, Didier, Loubet, Paul, Stephan, Robin, Chiaruzzi, Myriam, Clemmer, Edouard, Martin, Aurelie, Roger, Claire, Muller, Laurent, Claret, Pierre-Géraud, Goulabchand, Radjiv, Roux, Clarisse, Lavigne, Jean-Philippe, Sotto, Albert, Larcher, Romaric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9854884/
https://www.ncbi.nlm.nih.gov/pubmed/36671288
http://dx.doi.org/10.3390/antibiotics12010088
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author Laffont-Lozes, Paul
Laureillard, Didier
Loubet, Paul
Stephan, Robin
Chiaruzzi, Myriam
Clemmer, Edouard
Martin, Aurelie
Roger, Claire
Muller, Laurent
Claret, Pierre-Géraud
Goulabchand, Radjiv
Roux, Clarisse
Lavigne, Jean-Philippe
Sotto, Albert
Larcher, Romaric
author_facet Laffont-Lozes, Paul
Laureillard, Didier
Loubet, Paul
Stephan, Robin
Chiaruzzi, Myriam
Clemmer, Edouard
Martin, Aurelie
Roger, Claire
Muller, Laurent
Claret, Pierre-Géraud
Goulabchand, Radjiv
Roux, Clarisse
Lavigne, Jean-Philippe
Sotto, Albert
Larcher, Romaric
author_sort Laffont-Lozes, Paul
collection PubMed
description We aimed to assess the factors associated with mortality in patients treated with tocilizumab for a SARS-CoV-2 pneumonia due to the delta or omicron variants of concern (VOC) and detect an effect of tocilizumab on mortality. We conducted a prospective cohort study in a tertiary hospital from 1 August 2021 to 31 March 2022 including patients with severe COVID-19, treated with tocilizumab. Factors associated with mortality were assessed in a Cox model; then, the 60-day mortality rates of COVID-19 patients treated with standard of care (SoC) +/− tocilizumab were compared after 1:1 propensity score matching. The mortality rate was 22% (N = 26/118) and was similar between delta and omicron cases (p = 0.6). The factors independently associated with mortality were age (HR 1.06; 95% CI (1.02–1.11), p = 0.002), Charlson index (HR 1.33; 95% CI (1.11–1.6), p = 0.002), WHO-CPS (HR 2.56; 95% CI (1.07–6.22) p = 0.03), and tocilizumab infusion within the first 48 h following hospital admission (HR 0.37, 95% CI (0.14–0.97), p = 0.04). No significant differences in mortality between the tocilizumab plus SoC and SoC alone groups (p = 0.5) were highlighted. However, the patients treated with tocilizumab within the 48 h following hospital admission had better survival (p = 0.04). In conclusion, our results suggested a protective effect on mortality of the early administration of tocilizumab in patients with severe COVID-19 regardless of the VOC involved.
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spelling pubmed-98548842023-01-21 Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France Laffont-Lozes, Paul Laureillard, Didier Loubet, Paul Stephan, Robin Chiaruzzi, Myriam Clemmer, Edouard Martin, Aurelie Roger, Claire Muller, Laurent Claret, Pierre-Géraud Goulabchand, Radjiv Roux, Clarisse Lavigne, Jean-Philippe Sotto, Albert Larcher, Romaric Antibiotics (Basel) Article We aimed to assess the factors associated with mortality in patients treated with tocilizumab for a SARS-CoV-2 pneumonia due to the delta or omicron variants of concern (VOC) and detect an effect of tocilizumab on mortality. We conducted a prospective cohort study in a tertiary hospital from 1 August 2021 to 31 March 2022 including patients with severe COVID-19, treated with tocilizumab. Factors associated with mortality were assessed in a Cox model; then, the 60-day mortality rates of COVID-19 patients treated with standard of care (SoC) +/− tocilizumab were compared after 1:1 propensity score matching. The mortality rate was 22% (N = 26/118) and was similar between delta and omicron cases (p = 0.6). The factors independently associated with mortality were age (HR 1.06; 95% CI (1.02–1.11), p = 0.002), Charlson index (HR 1.33; 95% CI (1.11–1.6), p = 0.002), WHO-CPS (HR 2.56; 95% CI (1.07–6.22) p = 0.03), and tocilizumab infusion within the first 48 h following hospital admission (HR 0.37, 95% CI (0.14–0.97), p = 0.04). No significant differences in mortality between the tocilizumab plus SoC and SoC alone groups (p = 0.5) were highlighted. However, the patients treated with tocilizumab within the 48 h following hospital admission had better survival (p = 0.04). In conclusion, our results suggested a protective effect on mortality of the early administration of tocilizumab in patients with severe COVID-19 regardless of the VOC involved. MDPI 2023-01-04 /pmc/articles/PMC9854884/ /pubmed/36671288 http://dx.doi.org/10.3390/antibiotics12010088 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Laffont-Lozes, Paul
Laureillard, Didier
Loubet, Paul
Stephan, Robin
Chiaruzzi, Myriam
Clemmer, Edouard
Martin, Aurelie
Roger, Claire
Muller, Laurent
Claret, Pierre-Géraud
Goulabchand, Radjiv
Roux, Clarisse
Lavigne, Jean-Philippe
Sotto, Albert
Larcher, Romaric
Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France
title Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France
title_full Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France
title_fullStr Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France
title_full_unstemmed Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France
title_short Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France
title_sort effect of tocilizumab on mortality in patients with sars-cov-2 pneumonia caused by delta or omicron variants: a propensity-matched analysis in nimes university hospital, france
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9854884/
https://www.ncbi.nlm.nih.gov/pubmed/36671288
http://dx.doi.org/10.3390/antibiotics12010088
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