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

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

Expert Review of Clinical Pharmacology – Volume 14, 2021

DOI:10.1080/17512433.2021.1875819

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 dehydro-genase, 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.

Figures & data: Clinical course of severe patients with COVID-19 treated with tocilizumab: report from a cohort study in Spain (tandfonline.com)

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