Tocilizumab reduces COVID-19 mortality and pathology in a dose and timing-dependent fashion: a multi-centric study
| Autor: | Ángel Raúl Hernández-Romero, Alberto N. Peón, Antonio Ramos de la Medina, María Antonieta Solís-González, Daniela Pérez-Ortega, Shannat Ortega-Rodríguez, Miranda Tobón-Cubillos, Aldo Christiaan Jardínez-Vera, Fernanda Romero-Lechuga, Daniela Montaño-Olmos, Alma Delia Aguilar-Arroyo, Guillermo Montiel-Bravo, Alejandro Durán-Méndez, Perla Oriana-Román, Emiliano Vivanco-Gómez, Cristian Jiménez-Pérez, Jorge Rafael Flores-Hernández, Elizabeth Lagunes-Lara, Oscar J Roque-Reyes, Juan Daniel Méndez-Coca, América Viveros-Hernández, Diana Medina-Santos, Karla Y. Hernández-Skewes, Miguel Cova-Bonilla, Fernando Sevilla-Castillo, Karla Cecilia Farfán-Lazos, Eduardo Nieto-Ortega, Laura Martínez Pérez-Maldonado |
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| Rok vydání: | 2021 |
| Předmět: |
Pathology
medicine.medical_specialty Science Antibodies Monoclonal Humanized Severity of Illness Index Article Fibrin Fibrinogen Degradation Products chemistry.chemical_compound Tocilizumab Severity of illness Odds Ratio medicine Humans Survival rate Survival analysis Retrospective Studies Multidisciplinary Dose-Response Relationship Drug biology SARS-CoV-2 business.industry C-reactive protein COVID-19 Retrospective cohort study Odds ratio medicine.disease Survival Analysis COVID-19 Drug Treatment Survival Rate C-Reactive Protein chemistry Viral infection Molecularly targeted therapy Outcomes research biology.protein Medicine business Cytokine storm |
| Zdroj: | Scientific Reports, Vol 11, Iss 1, Pp 1-8 (2021) Scientific Reports |
| ISSN: | 2045-2322 |
| Popis: | Life-threatening COVID-19 is associated with strong inflammation, where an IL-6-driven cytokine storm appears to be a cornerstone for enhanced pathology. Nonetheless, the specific inhibition of such pathway has shown mixed outcomes. This could be due to variations in the dose of tocilizumab used, the stage in which the drug is administered or the severity of disease presentation. Thus, we performed a retrospective multicentric study in 140 patients with moderate to critical COVID-19, 79 of which received tocilizumab in variable standard doses ( 800 mg), either at the viral (1–7 days post-symptom onset), early inflammatory (8–15) or late inflammatory (16 or more) stages, and compared it with standard treated patients. Mortality, reduced respiratory support requirements and pathology markers were measured. Tocilizumab significantly reduced the respiratory support requirements (OR 2.71, CI 1.37–4.85 at 95%) and inflammatory markers (OR 4.82, CI 1.4–15.8) of all patients, but mortality was only reduced (4.1% vs 25.7%, p = 0.03) when the drug was administered at the early inflammatory stage and in doses ranging 400–800 mg in severely-ill patients. Despite the apparent inability of Tocilizumab to prevent the progression of COVID-19 into a critical presentation, severely-ill patients may be benefited by its use in the early inflammatory stage and moderate doses. |
| Databáze: | OpenAIRE |
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