Glucocorticoids alone versus tocilizumab alone or glucocorticoids plus tocilizumab in patients with severe SARS-CoV-2 pneumonia and mild inflammation
| Autor: | María Nuñez-Nuñez, Ismael Francisco Aomar-Millán, Juan Salvatierra, Úrsula Torres-Parejo, Francisco Anguita-Santos, José Hernández-Quero |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Methylprednisolone 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Internal medicine Medicine 030212 general & internal medicine Metilprednisolona Adverse effect Inflammation Inflamación business.industry Brief Report Mortality rate COVID-19 General Medicine medicine.disease Clinical trial Pneumonia Cytokine storm syndrome chemistry Síndrome de tormenta de citoquinas business Cohort study medicine.drug |
| Zdroj: | Medicina Clinica (English Ed.) |
| ISSN: | 2387-0206 |
| DOI: | 10.1016/j.medcle.2021.01.004 |
| Popis: | 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 [group I], tocilizumab alone [group II] and methylprednisolone plus tocilizumab [group III]). 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 group I and 6 (9,5%) in groups II and III. 15 (10,6%) were admitted to ICU: 2 (2,5%) from group I, 4 (28,5%) from group II and 9 (18,4%) from group III. The mean hospital stay was longer in group II 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. |
| Databáze: | OpenAIRE |
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