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. 2021 Feb;14(2):249-260.
doi: 10.1080/17512433.2021.1875819. Epub 2021 Jan 26.

Clinical course of severe patients with COVID-19 treated with tocilizumab: report from a cohort study in Spain

Esther Chamorro-de-Vega  1   2 , Carmen-Guadalupe Rodriguez-Gonzalez  1   2 , Silvia Manrique-Rodríguez  1   2 , Elena Lobato-Matilla  1   2 , Felix García-Moreno  1   2 , Maria Olmedo  2   3 , Rafael Correa-Rocha  2   4 , Maricela Valerio  2   3 , Teresa Aldámiz-Echevarria  2   3 , Marina Machado  2   3 , Milagros Sancho-Gonzalez  2   5 , Juan Carlos Lopez-Bernaldo-de-Quirós  2   3 , Paula Ruiz-Briones  1   2 , Rosa Romero-Jiménez  1   2 , Camino Sarobe-González  1   2 , Alvaro Gimenez-Manzorro  1   2 , Roberto Collado-Borrell  1   2 , Cecilia M Fernandez-Llamazares  1   2 , Jose Luis Revuelta-Herrero  1   2 , Beatriz Somoza-Fernandez  1   2 , Sebastian Garcia-Sanchez  1   2 , Irene Taladriz-Sender  1   2 , Emilio Bouza  2   3   6   7 , Ana Herranz  1   2 , Patricia Muñoz  2   3   6   7 , Maria Sanjurjo  1   2
Affiliations

Clinical course of severe patients with COVID-19 treated with tocilizumab: report from a cohort study in Spain

Esther Chamorro-de-Vega et al. Expert Rev Clin Pharmacol. 2021 Feb.

Abstract

Background: We report the long-term outcomes, changes in laboratory parameters, the incidence of secondary nosocomial infections and treatment cost of a Spanish cohort of patients with severe COVID-19 that received tocilizumab (TCZ).Methods: Retrospective cohort of PCR confirmed adult patients who received TCZ from March 1 to 24, 2020 in a tertiary hospital was analyzed. Patients were followed up until 10 May 2020.Results: We included 162 patients (median age 64 years; 70.4% male). At time of TCZ administration, 48.1% of patients were on invasive mechanical ventilation (IMV). Over a median follow-up of 53 days, 46.9% of patients were discharge in good conditions and 19.8% were still hospitalized. The overall mortality was 33.3%, being higher in patients on IMV than those who did not (46.2% vs 26.7%, P < 0.001). A significant improvement in the lymphocyte count, C-reactive protein, lactate dehydrogenase, and D-dimer was observed. Overall, 43.2% patients presented nosocomial infections, causing death in 8%. Infections were more prevalent in ICU units (63.0% vs 17.1%, P < 0.001). The total cost of TCZ was €371,784.Conclusions: Among the patients who used TCZ, one third died, regardless the improvement in some inflammatory biomarkers. The incidence of secondary nosocomial infections was high.

Keywords: COVID-19; SARS-CoV-2; Spain; mortality; tocilizumab.

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Figures

Figure 1.
Figure 1.
Kaplan-Meier survival estimates of the cumulative probability of death in the total population (1A) and in patients who received TCZ under IMV or not (1B)
Figure 2.
Figure 2.
Oxygen-support status at baseline and after TCZ treatment
Figure 3.
Figure 3.
Categorical summary of laboratory parameter after TCZ treatment
See this image and copyright information in PMC

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