AI Article Synopsis
- The study evaluated the effectiveness and safety of tocilizumab (TCZ) for patients with severe cytokine release syndrome due to SARS-CoV-2, focusing on factors influencing their recovery and mortality.
- A total of 75 hospitalized patients were analyzed, revealing that while TCZ treatment helped reduce certain symptoms like fever and severe forms of Acute Respiratory Distress Syndrome (ARDS), it was linked to increased mortality rates in those receiving multiple doses.
- The findings suggest TCZ improved some clinical outcomes, but its use did not lead to a decrease in death rates, with factors like hypertension and initial D-dimer levels being significant predictors of mortality.
Article Abstract
Background: This study was aimed to assess the efficacy and safety of tocilizumab (TCZ) and to investigate the factors related to the progress and mortality of patients with a secondary cytokine release syndrome caused by SARS-CoV-2.
Methods: A retrospective descriptive observational study of hospitalised patients with a positive polymerase chain reaction (PCR) result for SARS-CoV-2 and whose clinical evolution required the administration of one or more doses of TCZ was conducted. Demographic variables, clinical evolution, radiologic progress and analytical parameters were analysed on days 1, 3 and 5 after administration the first dose of TCZ.
Results: A total of 75 patients with a clinical history of Accurate Respiratory Distress Syndrome (ARDS) were analysed, among whom, 19 had mild ARDS (25.3%), 37 moderate ARDS (49.4%) and 19 severe ARDS (25.3%). Lymphocytopenia and high levels of PCR, D-Dimer and IL-6 were observed in almost all the patients (91.8%). Treatment with TCZ was associated with a reduction of lymphocytopenia, C-reactive protein (CRP) levels, severe ARDS cases and fever. Although a better evolution of PaO/FiO was observed in patients who received two or more doses of TCZ (38/75), there was an increase in their mortality (47.4%) and ICU admission (86.8%). The 30-day mortality rate was 30.7% (20.5-42.4% CI) being hypertension, high initial D-dimer levels and ICU admission the only predictive factors found.
Conclusion: Based on our results, treatment with TCZ was associated with a fever, swelling and ventilator support improvement. However, there is no evidence that the administration of two or more doses of TCZ was related to a mortality decrease.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650573 | PMC |
| http://dx.doi.org/10.1007/s43440-020-00186-z | DOI Listing |
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