Tocilizumab in COVID-19: Factors Associated With Mortality Before and After Treatment
Metadatos
Mostrar el registro completo del ítemAutor
Sarabia de Ardanaz, Luis; Andreu Ubero, José María; Navidad Fuentes, Miriam; Ferrer González, Miguel Ángel; Ruiz del Valle, Víctor; Salcedo Bellido, Inmaculada; Barrios Rodríguez, Rocío; Cáliz Cáliz, Antonio Rafael; Requena Méndez, María del PilarEditorial
Frontiers Research Foundation
Materia
COVID-19 Immunosupression Tocilizumab Mortality Risk factor Platelet
Fecha
2021-07-01Referencia bibliográfica
Sarabia De Ardanaz L... [et al.] (2021) Tocilizumab in COVID-19: Factors Associated With Mortality Before and After Treatment. Front. Pharmacol. 12:620187. doi: [10.3389/fphar.2021.620187]
Resumen
Tocilizumab (TCZ) has been administered in SARS-CoV-2 pneumonia but the factors
associated with mortality before and after treatment remain unclear. Cox regression
models were used to estimate the predictors of time to death in a cohort of hospitalized
patients with COVID-19 receiving TCZ. In addition, the mean differences between
discharged and deceased patients in laboratory parameters measured before and 3, 6
and 9 days after TCZ administration were estimated with weighted generalized
estimation equations. The variables associated with time to death were
immunosuppression (Hazard Ratio-HR 3.15; 95% confidence interval-CI 1.17,
8.51), diabetes mellitus (HR 2.63; 95% CI 1.23–5.64), age (HR 1.05; 95% CI
1.02–1.09), days since diagnosis until TCZ administration (HR 1.05, 95% CI
1.00–1.09), and platelets (HR 0.27; 95% CI: 0.11, 0.69). In the post-TCZ analysis
and compared to discharged patients, deceased patients had more lactate
dehydrogenase (p 0.013), troponin I (p 0.013), C-reactive protein (p 0.013),
neutrophils (p 0.024), and fewer platelets (p 0.013) and lymphocytes (p 0.013) as
well as a lower average PaO2/FiO2 ratio. In conclusion, in COVID-19 diagnosed
patients receiving TCZ, early treatment decreased the risk of death, while age,
some comorbidities and baseline lower platelet counts increased that risk. After
TCZ administration, lower platelet levels were again associated with mortality,
together with other laboratory parameters.