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Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis
BACKGROUND: SARS-CoV-2 infection demonstrates a wide range of severity. More severe cases demonstrate a cytokine storm with elevated serum interleukin-6, hence IL-6 receptor antibody tocilizumab was tried for the management of severe cases. AIMS: Effect of tocilizumab on ventilator-free days among c...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sciendo
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949015/ https://www.ncbi.nlm.nih.gov/pubmed/36844963 http://dx.doi.org/10.2478/rjaic-2022-0001 |
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author | Mady, Ahmed F. Abdulrahman, Basheer Mumtaz, Shahzad A. Al-Odat, Mohammed A. Kuhail, Ahmed Altoraifi, Rehab Alshae, Rayan Alharthy, Abdulrahman M. Karakitsos, Dimitrios Aletreby, Waleed Th. |
author_facet | Mady, Ahmed F. Abdulrahman, Basheer Mumtaz, Shahzad A. Al-Odat, Mohammed A. Kuhail, Ahmed Altoraifi, Rehab Alshae, Rayan Alharthy, Abdulrahman M. Karakitsos, Dimitrios Aletreby, Waleed Th. |
author_sort | Mady, Ahmed F. |
collection | PubMed |
description | BACKGROUND: SARS-CoV-2 infection demonstrates a wide range of severity. More severe cases demonstrate a cytokine storm with elevated serum interleukin-6, hence IL-6 receptor antibody tocilizumab was tried for the management of severe cases. AIMS: Effect of tocilizumab on ventilator-free days among critically ill SARS-CoV-2 patients. METHOD: Retrospective propensity score matching study, comparing mechanically ventilated patients who received tocilizumab to a control group. RESULTS: 29 patients in the intervention group were compared to 29 controls. Matched groups were similar. Ventilator-free days were more numerous in the intervention group (SHR 2.7, 95% CI: 1.2 – 6.3; p = 0.02), ICU mortality rate was not different (37.9% versus 62%, p = 0.1), actual ventilator-free periods were significantly longer in tocilizumab group (mean difference 4.7 days; p = 0.02). Sensitivity analysis showed a significantly lower hazard ratio of death in tocilizumab group (HR 0.49, 95% CI: 0.25 – 0.97; p = 0.04). There was no difference in positive cultures among groups (55.2% in tocilizumab group versus 34.5% in the control; p = 0.1). CONCLUSION: Tocilizumab may improve the composite outcome of ventilator-free days at day 28 among mechanically ventilated SARS-CoV-2 patients; it is associated with significantly longer actual ventilator-free periods, and insignificantly lower mortality and higher superinfection. |
format | Online Article Text |
id | pubmed-9949015 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Sciendo |
record_format | MEDLINE/PubMed |
spelling | pubmed-99490152023-02-24 Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis Mady, Ahmed F. Abdulrahman, Basheer Mumtaz, Shahzad A. Al-Odat, Mohammed A. Kuhail, Ahmed Altoraifi, Rehab Alshae, Rayan Alharthy, Abdulrahman M. Karakitsos, Dimitrios Aletreby, Waleed Th. Rom J Anaesth Intensive Care Original Paper BACKGROUND: SARS-CoV-2 infection demonstrates a wide range of severity. More severe cases demonstrate a cytokine storm with elevated serum interleukin-6, hence IL-6 receptor antibody tocilizumab was tried for the management of severe cases. AIMS: Effect of tocilizumab on ventilator-free days among critically ill SARS-CoV-2 patients. METHOD: Retrospective propensity score matching study, comparing mechanically ventilated patients who received tocilizumab to a control group. RESULTS: 29 patients in the intervention group were compared to 29 controls. Matched groups were similar. Ventilator-free days were more numerous in the intervention group (SHR 2.7, 95% CI: 1.2 – 6.3; p = 0.02), ICU mortality rate was not different (37.9% versus 62%, p = 0.1), actual ventilator-free periods were significantly longer in tocilizumab group (mean difference 4.7 days; p = 0.02). Sensitivity analysis showed a significantly lower hazard ratio of death in tocilizumab group (HR 0.49, 95% CI: 0.25 – 0.97; p = 0.04). There was no difference in positive cultures among groups (55.2% in tocilizumab group versus 34.5% in the control; p = 0.1). CONCLUSION: Tocilizumab may improve the composite outcome of ventilator-free days at day 28 among mechanically ventilated SARS-CoV-2 patients; it is associated with significantly longer actual ventilator-free periods, and insignificantly lower mortality and higher superinfection. Sciendo 2023-01-14 /pmc/articles/PMC9949015/ /pubmed/36844963 http://dx.doi.org/10.2478/rjaic-2022-0001 Text en © 2022 Ahmed F. Mady et al., published by Sciendo https://creativecommons.org/licenses/by-nc-nd/3.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. |
spellingShingle | Original Paper Mady, Ahmed F. Abdulrahman, Basheer Mumtaz, Shahzad A. Al-Odat, Mohammed A. Kuhail, Ahmed Altoraifi, Rehab Alshae, Rayan Alharthy, Abdulrahman M. Karakitsos, Dimitrios Aletreby, Waleed Th. Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis |
title | Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis |
title_full | Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis |
title_fullStr | Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis |
title_full_unstemmed | Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis |
title_short | Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis |
title_sort | effect of tocilizumab on “ventilator free days” composite outcome in sars-cov-2 patients: a retrospective competing risk analysis |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949015/ https://www.ncbi.nlm.nih.gov/pubmed/36844963 http://dx.doi.org/10.2478/rjaic-2022-0001 |
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