Predictors of Mortality Amongst Tocilizumab Administered COVID-19 Asian Indians: A Premonition Study From a Tertiary Care Centre
| Autor: | Hardik D Desai, Rupak Desai, Karan Patel, Smeet Patel, Saurav Kini, Parth P Patel, Jayesh Trivedi, Zeel Patel, Atul Parikh, Kamal Kumar Sharma |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) Infectious Disease 030204 cardiovascular system & hematology Tertiary care tocilizumab 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Diabetes mellitus Internal medicine Internal Medicine medicine predictors of mortality business.industry General Engineering Cancer medicine.disease Comorbidity sars-cov-2 Pneumonia covid-19 chemistry business Complication 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Introduction Hyper-cytokinemia is a dreaded complication of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection and an important predictor of mortality in coronavirus disease 2019 (COVID-19). The current evidence at best is still ambiguous for use of tocilizumab in cytokine storm in COVID-19. Moreover, the factors that are associated with beneficial response from tocilizumab are unknown in COVID-19. We aimed to study the clinical outcomes especially mortality vis-à-vis clinical and laboratory characteristics of patients administered tocilizumab and identify predictors of mortality benefits amongst deceased vs recovered COVID-19 patients. Methods The present study is a retrospective observation of the demographic, clinical, and biological data of all the consecutive patients treated with tocilizumab for COVID-19 pneumonia at the COVID tertiary care centre from July 2020 to October 2020 at Ahmedabad, India. We compared the deceased group with those who recovered/discharged and evaluated patient-level demographics, clinical attributes, and laboratory investigations available to identify subgroups in whom tocilizumab reduced mortality. Results Of the 112 patients included, the mean (SD) age was 56.84 ± 13.56 years and 80 (71.4%) were male. There were 97 (86.6%) patients in the survivors and 15 (13.39%) in the deceased group. Deceased were older than the recovered group (mean: 66.14, SD: 14.41 vs mean: 55.36, SD: 12.98; p=0.04). Hypertension (33.03%) was the commonest comorbidity observed. Mortality was significantly higher in patients with cancer and type-2 diabetes (p=0.05 and p=0.01, respectively). Level of D-dimer and lactate dehydrogenase (LDH) showed trends towards significance as a predictor of mortality (p=0.07 and p=0.08, respectively) not reaching significance. D‐dimer level > 5,000 nanograms per millilitre (ng/mL) was the significant predictor of subsequent deaths (p 5,000 ng/mL. A larger study with pre-defined inclusion cut-offs of these variables may aid in defining patient's characteristics of Asian Indians who may benefit from tocilizumab in COVID-19. |
| Databáze: | OpenAIRE |
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