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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...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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. |
format | Online Article Text |
id | pubmed-9854884 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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