Analysis of the factors predicting clinical response to tocilizumab therapy in patients with severe COVID-19.
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ABSTRACT: Background
Controversy remains about the efficacy of tocilizumab (TCZ) for the treatment of severe COVID-19. We aimed to analyze the profile of TCZ-respondent patients.Methods
We retrospectively analyzed a cohort of patients with severe COVID-19 admitted to the University Hospital "12 de Octubre" until May, 2020 that received off-label TCZ after indication of a local Committee. The primary end point was significant clinical improvement at day 14 after TCZ (SCI). Factors independently related with SCI were analyzed by multivariate logistic regression models.Results
Out of 428 patients treated with TCZ, 271(63.3%) experienced SCI. After adjustment by factors related with unfavorable outcome, TCZ administration within the first 48 hours from admission (odds ratio [OR]: 1.98, 95% confidence Interval [95% CI]: 1.1 - 3.55; P-value = 0.02) and ALT levels >100 UI/L at day 0 (OR: 3.28; 95% CI:1.3 -8.1; P-value = 0.01) were independently related with SCI. The rate of SCI significantly decreased according timing of TCZ: 70.2% first 48 hours from admission, 58.5% day 3 to 7 and 45.1% beyond day 7 (P-values = 0.03 and 0.001 respectively).Conclusion
TCZ improves the prognosis of patients with COVID-19 mostly if treatment is started within the first 48 hours of admission.
SUBMITTER: San-Juan R
PROVIDER: S-EPMC8783837 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description: Not available
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