Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Jun 25;156(12):602-605.
doi: 10.1016/j.medcli.2021.01.006. Epub 2021 Jan 28.

Glucocorticoids alone versus tocilizumab alone or glucocorticoids plus tocilizumab in patients with severe SARS-CoV-2 pneumonia and mild inflammation

[Article in English, Spanish]
Ismael Francisco Aomar-Millán  1 , Juan Salvatierra  2 , Úrsula Torres-Parejo  3 , María Nuñez-Nuñez  4 , José Hernández-Quero  5 , Francisco Anguita-Santos  5
Affiliations
Case Reports

Glucocorticoids alone versus tocilizumab alone or glucocorticoids plus tocilizumab in patients with severe SARS-CoV-2 pneumonia and mild inflammation

[Article in English, Spanish]
Ismael Francisco Aomar-Millán et al. Med Clin (Barc). .

Abstract

Aim: To assess clinical outcomes according to the immunosuppressive treatment administered to patients with severe SARS-CoV-2 pneumonia and moderate inflammation.

Methods: A retrospective observational cohort study involving 142 patients with severe COVID-19 pneumonia and moderate inflammation divided into three treatment groups (pulses of methylprednisolone alone [groupI], tocilizumab alone [groupII] and methylprednisolone plus tocilizumab [groupIII]). The aim was to assess intergroups differences in the clinical course with a 60-day follow-up and related analytical factors.

Results: 14 patients (9,8%) died: 8 (10%) in groupI and 6 (9,5%) in groupsII andIII. 15 (10,6%) were admitted to ICU: 2 (2,5%) from groupI, 4 (28,5%) from groupII and 9 (18,4%) from groupIII. The mean hospital stay was longer in groupII and clinical outcome was not associated with treatment.

Conclusions: Tocilizumab seems to be not associated with better clinical outcomes and should be reserved for clinical trial scenario, since its widespread use may result in higher rate of ICU admission and longer mean hospital stay without differences in mortality rate and potentially adverse events.

Keywords: COVID-19; Cytokine storm syndrome; Inflamación; Inflammation; Methylprednisolone; Metilprednisolona; Síndrome de tormenta de citoquinas; Tocilizumab.

PubMed Disclaimer

Figures

Figura 1
Figura 1
Días de estancia media hospitalaria según tratamiento recibido.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395:1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed
    1. Horby P., Lim W.S., Emberson J.R., Mafham M., Bell J.L., Linsell L., et al. RECOVERY Collaborative Group Dexamethasone in hospitalized patients with Covid-19 — Preliminary report. N Engl J Med. 2020 doi: 10.1056/NEJMoa2021436. - DOI - PMC - PubMed
    1. Fadel R., Morrison A.R., Vahia A., Smith Z.R., Chaudhry Z., Bhargava P., et al. Early short course corticosteroids in hospitalized patients with COVID-19. Clin Infect Dis. 2020;71:2114–2120. doi: 10.1093/cid/ciaa601. - DOI - PMC - PubMed
    1. Ramiro S., Mostard R.L.M., Magro-Checa C., van Dongen C.M.P., Dormans T., Buijs J., et al. Historically controlled comparison of glucocorticoids with or without tocilizumab versus supportive care only in patients with COVID-19-associated cytokine storm syndrome: Results of the CHIC study. Ann Rheum Dis. 2020;79:1143–1151. doi: 10.1136/annrheumdis-2020-218479. - DOI - PMC - PubMed
    1. Guaraldi G., Marianna Meschiari M., Cozzi-Lepri A., Milic J., Tonelli R., Menozzi M., et al. Tocilizumab in patients with severe COVID-19: A retrospective cohort study. Lancet Rheumatol. 2020;2:e474–e484. doi: 10.1016/S2665-9913(20)30173-9. - DOI - PMC - PubMed