| Autor: |
Francisco López-Medrano, María Asunción Pérez-Jacoiste Asín, Mario Fernández-Ruiz, Octavio Carretero, Antonio Lalueza, Guillermo Maestro de la Calle, José Manuel Caro, Cristina de la Calle, Mercedes Catalán, Rocío García-García, Joaquín Martínez-López, Julia Origüen, Mar Ripoll, Rafael San Juan, Hernando Trujillo, Ángel Sevillano, Eduardo Gutiérrez, Borja de Miguel, Fernando Aguilar, Carlos Gómez, José Tiago Silva, Daniel García-Ruiz de Morales, Miguel Saro-Buendía, Ángel Marrero-Sánchez, Guillermo Chiara-Graciani, Héctor Bueno, Estela Paz-Artal, Carlos Lumbreras, José L. Pablos, José María Aguado |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
International Journal of Infectious Diseases, Vol 105, Iss , Pp 487-494 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
1201-9712 |
| DOI: |
10.1016/j.ijid.2021.02.099 |
| Popis: |
Background: The role of combination immunomodulatory therapy with systemic corticosteroids and tocilizumab (TCZ) for aged patients with COVID-19-associated cytokine release syndrome remains unclear. Methods: A retrospective single-center study was conducted on consecutive patients aged ≥65 years who developed severe COVID-19 between 03 March and 01 May 2020 and were treated with corticosteroids at various doses (methylprednisolone 0.5 mg/kg/12 h to 250 mg/24 h), either alone (CS group) or associated with intravenous tocilizumab (400–600 mg, one to three doses) (CS-TCZ group). The primary outcome was all-cause mortality by day +14, whereas secondary outcomes included mortality by day +28 and clinical improvement (discharge and/or a ≥2 point decrease on a 6-point ordinal scale) by day +14. Propensity score (PS)-based adjustment and inverse probability of treatment weights (IPTW) were applied. Results: Totals of 181 and 80 patients were included in the CS and CS-TCZ groups, respectively. All-cause 14-day mortality was lower in the CS-TCZ group, both in the PS-adjusted (hazard ratio [HR]: 0.34; 95% confidence interval [CI]: 0.17–0.68; P = 0.002) and IPTW-weighted models (odds ratio [OR]: 0.38; 95% CI: 0.21–0.68; P = 0.001). This protective effect was also observed for 28-day mortality (PS-adjusted HR: 0.38; 95% CI: 0.21–0.72; P = 0.003). Clinical improvement by day +14 was higher in the CS-TCZ group with IPTW analysis only (OR: 2.26; 95% CI: 1.49–3.41; P |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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