Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness
Author
Rubio-Rivas, Manuel
Ronda, Mar
Padullés, Ariadna
Mitjavila, Francesca
Riera-Mestre, Antoni
García-Forero, Carlos
Iriarte, Adriana
Mora-Luján, José María
Padullés, Núria
Gonzalez, Monica
Solanich, Xavier
Gasa, Merce
Suarez-Cuartin, Guillermo
Sabater-Riera, Joan
Perez-Fernandez, Xose L.
Santacana, Eugenia
Leiva, Elisabet
Ariza-Sole, Albert
Dallaglio, Paolo D.
Quero, Maria
Soriano, Antonio
Pasqualetto, Alberto
Koo, Maylin
Esteve-Luque, Virginia
Antolí, Arnau
Moreno-Gónzalez, Rafael
Yun, Sergi
Cerdà, Pau
Llaberia, Mariona
Formiga, Francesc
Fanlo-Maresma, Marta
Montero, Abelardo
Chivite, David
Capdevila, Olga
Bolao, Ferran
Pintó, Xavier
Llop, Josep
Sabate, Antoni
Guardiola, Jordi
Cruzado, Josep M.
Comin-Colet, Josep
Santos, Salud
Jodar, Ramon
Corbella Virós, Xavier
Publication date
2020-12ISSN
1201-9712
Abstract
Objectives: To assess the characteristics and risk factors for mortality in patients with severe coronavirus disease-2019 (COVID-19) treated with tocilizumab (TCZ), alone or in combination with corticosteroids (CS). Methods: From March 17 to April 7, 2020, a real-world observational retrospective analysis of consecutive hospitalized adult patients receiving TCZ to treat severe COVID-19 was conducted at our 750-bed university hospital. The main outcome was all-cause in-hospital mortality. Results: A total of 1,092 patients with COVID-19 were admitted during the study period. Of them, 186 (17%) were treated with TCZ, of which 129 (87.8%) in combination with CS. Of the total 186 patients, 155 (83.3 %) patients were receiving noninvasive ventilation when TCZ was initiated. Mean time from symptoms onset and hospital admission to TCZ use was 12 (±4.3) and 4.3 days (±3.4), respectively. Overall, 147 (79%) survived and 39 (21%) died. By multivariate analysis, mortality was associated with older age (HR = 1.09, p < 0.001), chronic heart failure (HR = 4.4, p = 0.003), and chronic liver disease (HR = 4.69, p = 0.004). The use of CS, in combination with TCZ, was identified as a protective factor against mortality (HR = 0.26, p < 0.001) in such severe COVID-19 patients receiving TCZ. No serious superinfections were observed after a 30-day follow-up. Conclusions: In patients with severe COVID-19 receiving TCZ due to systemic host-immune inflammatory response syndrome, the use of CS in addition to TCZ therapy, showed a beneficial effect in preventing in-hospital mortality.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
616.9 - Communicable diseases. Infectious and contagious diseases, fevers
Keywords
Esteroides
Corticosteroides
COVID-19 (Malaltia)
Mortalitat
Esteroides
Corticosteroides
COVID-19
Mortalidad
Steroids
Corticosteroids
COVID-19
Mortality
Pages
8
Publisher
International Journal of Infectious Diseases
Collection
101;
Is part of
Elsevier
Citation
Rubio-Rivas, Manuel; Ronda, Mar; Padulles, Ariadna [et al.].
Rubio-Rivas, Manuel; Ronda, Mar; Padulles, Ariadna [et al.]. Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness. International Journal of Infectious Diseases, 2020, 101, p. 290-297. Disponible en: <https://pubmed.ncbi.nlm.nih.gov/33035673/>. Fecha de acceso: 12 ene. 2021. DOI: 10.1016/j.ijid.2020.09.1486
This item appears in the following Collection(s)
- Ciències de la Salut [740]
Rights
© 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.This is an open access article under the CCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc-nd/4.0/