Matched cohort study on the efficacy of tocilizumab in patients with COVID-19

One Health

Carlos Pérez-López¹  Oscar Macho²  Antonio Chamero Pastilla³  Maria Dolores Dapena³  Ester Ventosa Gili³  Andreu Fenollosa Artés³  Ezequiel Rodríguez³  Clara Gris Ambros³  Antonio Miñarro³  Natàlia Vidal Meler³  Gemma Añaños Carrasco³  Lourdes Hernandez Martinez³  Ernesto E. Monaco³  Sergi Martínez³  Italo G. Pisani Zambrano³  Antonio Hidalgo García³  Maria del Mar Segura Martin³  Maria Teresa Robles³  Anna Alberti Casas³  Gabriela F. López³  Manel Borrego Ruiz³  Jose L. Avalos Garcia³  Núria Milà Ràfols³  Laura Peramiquel Fonollosa³  Juan P. Rives³  Yris M. Sanchez Rodriguez³  Mireia Martín Puig³  Pedro L. Campo Pisa³  Alejandro Rodríguez-Molinero³  José C. Molina Hinojosa³  Enric Sabria Bach³  Florencia I. Venturini Cabanellas³  Isabel Collado Pérez³  Gemma Tremosa Llurba³  Ana M. Capielo Fornerino³  César Gálvez-Barrón⁴ 

[1] Corresponding author at: Àrea de Recerca, Consorci Sanitari de l'Alt Penedès i Garraf, Avinguda de l'Espirall 61, 08720 Vilafranca del Penedès Barcelona, Spain.;Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, Barcelona, Spain;Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain;Technical Research Center for Dependency Care and Autonomous Living (CETpD), Universitat Politècnica de Catalunya, Vilanova i la Geltru, Spain;

关键词: Tocilizumab;    Efficacy;    Coronavirus;    Sars-cov-2;    Observational study;    Cohort;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Tocilizumab has been proposed as a treatment for the new disease COVID-19, however, there is not enough scientific evidence to support this treatment. The objective of this study is to analyze whether the use of tocilizumab is associated with respiratory improvement and a shorter time to discharge in patients with COVID-19 and lung involvement. Methods: Observational study on a cohort of 418 patients, admitted to three county hospitals in Catalonia (Spain). Patients admitted consecutively were included and followed until discharge or up to 30 days of admission. A sub-cohort of patients treated with tocilizumab and a sub-cohort of control patients were identified, matched by a large number of risk factors and clinical variables. Sub-cohorts were also matched by the number of other treatments for COVID-19 that patients received. Increment in SAFI (inspired oxygen fraction / saturation) 48 h after the start of treatment, and time to discharge, were the primary outcomes. Mortality, which was a secondary outcome, was analyzed in the total cohort, by using logistic regression models, adjusted by confounders. Results: There were 96 patients treated with tocilizumab. Of them, 22 patients could be matched with an equivalent number of control patients. The increment in SAFI from baseline to 48 h of treatment, was not significantly different between groups (tocilizumab: −0.04; control: 0.09; p = 0.636). Also, no difference in time to discharge was found between the two sub-cohorts (logrank test: p = 0.472). The logistic regression models, did not show an effect of tocilizumab on mortality (OR 0.99; p = 0.990). Conclusions: We did not find a clinical benefit associated with the use tocilizumab, in terms of respiratory function at 48 h of treatment, or time to discharge.

【 授权许可】

Unknown