| Autor: |
Mihaela Sava, Gregor Sommer, Thomas Daikeler, Anne-Kathrin Woischnig, Aurélien E. Martinez, Karoline Leuzinger, Hans H. Hirsch, Tobias E. Erlanger, Andrea Wiencierz, Stefano Bassetti, Michael Tamm, Sarah Tschudin-Sutter, Marcel Stoeckle, Hans Pargger, Martin Siegemund, Renate Boss, Gert Zimmer, Diem-Lan Vu, Laurent Kaiser, Salome Dell-Kuster, Maja Weisser, Manuel Battegay, Katrin E. Hostettler, Nina Khanna |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
Swiss Medical Weekly, Vol 151, Iss 3132 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
1424-3997 |
| DOI: |
10.4414/smw.2021.20550 |
| Popis: |
OBJECTIVES Patients with severe COVID-19 may be at risk of longer term sequelae. Long-term clinical, immunological, pulmonary and radiological outcomes of patients treated with anti-inflammatory drugs are lacking. METHODS In this single-centre prospective cohort study, we assessed 90-day clinical, immunological, pulmonary and radiological outcomes of hospitalised patients with severe COVID-19 treated with tocilizumab from March 2020 to May 2020. Criteria for tocilizumab administration were oxygen saturation 30/min, C-reactive protein levels >75 mg/l, extensive area of ground-glass opacities or progression on computed tomography (CT). Descriptive analyses were performed using StataIC 16. RESULTS Between March 2020 and May 2020, 50 (27%) of 186 hospitalised patients had severe COVID-19 and were treated with tocilizumab. Of these, 52% were hospitalised on the intensive care unit (ICU) and 12% died. Eleven (22%) patients developed at least one microbiologically confirmed super-infection, of which 91% occurred on ICU. Median duration of hospitalisation was 15 days (interquartile range [IQR] 10–24) with 24 days (IQR 14–32) in ICU patients and 10 days (IQR 7–15) in non-ICU patients. At day 90, 41 of 44 survivors (93%) were outpatients. No long-term adverse events or late-onset infections were identified after acute hospital care. High SARS-CoV-2 antibody titres were found in all but one patient, who was pretreated with rituximab. Pulmonary function tests showed no obstructive patterns, but restrictive patterns in two (5.7%) and impaired diffusion capacities for carbon monoxide in 11 (31%) of 35 patients, which predominated in prior ICU patients. Twenty-one of 35 (60%) CT-scans at day 90 showed residual abnormalities, with similar distributions between prior ICU and non-ICU patients. CONCLUSIONS In this cohort of severe COVID-19 patients, no tocilizumab-related long-term adverse events or late-onset infections were identified. Although chest CT abnormalities were highly prevalent at day 90, the majority of patients showed normal lung function. Trial registration ClinicalTrials.gov NCT04351503 |
| Databáze: |
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| Externí odkaz: |
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