Benefits of early aggressive immunomodulatory therapy (tocilizumab and methylprednisolone) in COVID-19: Single center cohort study of 685 patients
| Autor: | Ossa-Echeverri Sergio, Barraza-Bengoechea Julio César, Iglesias-Posadilla David, Gero-Escapa María, Callejo-Torre Fernando, Megías-Lobón Gregoria, Delgado-López Pedro, Colazo-Burlato María, Lorenzo-Martín Andrés, Fernández-Regueras María, Galacho-Harriero Ana, De La Torre-Ferrera Noelia, García-Muñoz Juan Pablo, Ubeira Iglesias Marta, Hermida-Fernández Gerardo, Buzón-Martín Luis, Montero-Baladía Miguel, Astigarraga Itziar, López-Veloso María, Boado-Lama Jorge, Iglesias-Julián Enrique, Fernández-Ratero José Antonio, Fisac-Cuadrado Lourdes, San Llorente Sebastián Rodrigo, Navarro-San Francisco Carolina, Simón-Rodríguez Adolfo, Minguito de la Iglesia Javier |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Epidemiology Immunology immunomodulation Single Center Asymptomatic Article Immunomodulation chemistry.chemical_compound Tocilizumab Internal medicine Diagnosis medicine Immunology and Allergy respiratory-distress-syndrome business.industry SARS-CoV-2 Incidence (epidemiology) COVID-19 Lopinavir RC581-607 Coronavirus Treatment society chemistry cytokine storm Cohort epidemiology Immunologic diseases. Allergy medicine.symptom business Complication diagnosis treatment Cohort study medicine.drug |
| Zdroj: | Journal of Translational Autoimmunity Addi. Archivo Digital para la Docencia y la Investigación instname Journal of Translational Autoimmunity, Vol 4, Iss, Pp 100086-(2021) |
| ISSN: | 2589-9090 |
| Popis: | Introduction: A growing evidence suggests that immune dysregulation and thrombotic phenomena are key features in the pathophysiology of COVID-19. Apart from antivirals and respiratory support, anticoagulants, corticoids and immunomodulators are increasingly being prescribed, especially for more severe cases. We describe the clinical outcome of a large cohort of patients preferentially treated with glucocorticoids and interleukin inhibitors. Methods: Single center and retrospective case series. Adult patients admitted with COVID-19 related respiratory insufficiency were included. Patients who died within 2 days after admission and those testing positive but asymptomatic were excluded. We defined two study periods: from March 3rd to March 31 st, 2020 (beginning of epidemic until peak of incidence) and April 1 st to May 7 th, 2020 (second half of epidemic). The majority of patients received respiratory support, combinations of antimicrobials, anticoagulants, corticoids and interleukin inhibitors. Antivirals were preferentially given in the first period. The clinical outcome (death and ventilator dependency) of both periods was compared. Results: From March 3 rd to May 7 th, 685 patients were included for analysis (58.4% males, mean age 68.9 years). Patients in the first period (n = 408) were younger (66.6 vs 71.1 years, p = 0.003), presented lower mean P a O 2/F i O2 ratio at admission (256.5 vs 270.4 mm Hg,p = 0.0563), higher ferritin (1520 vs 1221 ng/ml, p = 0.01), higher IL-6 (679 vs 194 pg/ml, p |
| Databáze: | OpenAIRE |
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