One Health (Jun 2021)
Matched cohort study on the efficacy of tocilizumab in patients with COVID-19
- Alejandro Rodríguez-Molinero,
- Carlos Pérez-López,
- César Gálvez-Barrón,
- Antonio Miñarro,
- Oscar Macho,
- Gabriela F. López,
- Maria Teresa Robles,
- Maria Dolores Dapena,
- Sergi Martínez,
- Ezequiel Rodríguez,
- Isabel Collado Pérez,
- Anna Alberti Casas,
- Jose L. Avalos Garcia,
- Manel Borrego Ruiz,
- Gemma Añaños Carrasco,
- Pedro L. Campo Pisa,
- Ana M. Capielo Fornerino,
- Antonio Chamero Pastilla,
- Andreu Fenollosa Artés,
- Clara Gris Ambros,
- Lourdes Hernandez Martinez,
- Antonio Hidalgo García,
- Mireia Martín Puig,
- Núria Milà Ràfols,
- José C. Molina Hinojosa,
- Ernesto E. Monaco,
- Laura Peramiquel Fonollosa,
- Italo G. Pisani Zambrano,
- Juan P. Rives,
- Enric Sabria Bach,
- Yris M. Sanchez Rodriguez,
- Maria del Mar Segura Martin,
- Gemma Tremosa Llurba,
- Ester Ventosa Gili,
- Florencia I. Venturini Cabanellas,
- Natàlia Vidal Meler
Affiliations
- Alejandro Rodríguez-Molinero
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain; Corresponding author at: Àrea de Recerca, Consorci Sanitari de l'Alt Penedès i Garraf, Avinguda de l'Espirall 61, 08720 Vilafranca del Penedès Barcelona, Spain.
- Carlos Pérez-López
- Technical Research Center for Dependency Care and Autonomous Living (CETpD), Universitat Politècnica de Catalunya, Vilanova i la Geltru, Spain
- César Gálvez-Barrón
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Antonio Miñarro
- Department of Genetics, Microbiology and Statistics, School of Biology, University of Barcelona, Barcelona, Spain
- Oscar Macho
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Gabriela F. López
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Maria Teresa Robles
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Maria Dolores Dapena
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Sergi Martínez
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Ezequiel Rodríguez
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Isabel Collado Pérez
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Anna Alberti Casas
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Jose L. Avalos Garcia
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Manel Borrego Ruiz
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Gemma Añaños Carrasco
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Pedro L. Campo Pisa
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Ana M. Capielo Fornerino
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Antonio Chamero Pastilla
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Andreu Fenollosa Artés
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Clara Gris Ambros
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Lourdes Hernandez Martinez
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Antonio Hidalgo García
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Mireia Martín Puig
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Núria Milà Ràfols
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- José C. Molina Hinojosa
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Ernesto E. Monaco
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Laura Peramiquel Fonollosa
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Italo G. Pisani Zambrano
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Juan P. Rives
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Enric Sabria Bach
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Yris M. Sanchez Rodriguez
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Maria del Mar Segura Martin
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Gemma Tremosa Llurba
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Ester Ventosa Gili
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Florencia I. Venturini Cabanellas
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Natàlia Vidal Meler
- Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain
- Journal volume & issue
-
Vol. 12
p. 100214
Abstract
Background: Tocilizumab has been proposed as a treatment for the new disease COVID-19, however, there is not enough scientific evidence to support this treatment. The objective of this study is to analyze whether the use of tocilizumab is associated with respiratory improvement and a shorter time to discharge in patients with COVID-19 and lung involvement. Methods: Observational study on a cohort of 418 patients, admitted to three county hospitals in Catalonia (Spain). Patients admitted consecutively were included and followed until discharge or up to 30 days of admission. A sub-cohort of patients treated with tocilizumab and a sub-cohort of control patients were identified, matched by a large number of risk factors and clinical variables. Sub-cohorts were also matched by the number of other treatments for COVID-19 that patients received. Increment in SAFI (inspired oxygen fraction / saturation) 48 h after the start of treatment, and time to discharge, were the primary outcomes. Mortality, which was a secondary outcome, was analyzed in the total cohort, by using logistic regression models, adjusted by confounders. Results: There were 96 patients treated with tocilizumab. Of them, 22 patients could be matched with an equivalent number of control patients. The increment in SAFI from baseline to 48 h of treatment, was not significantly different between groups (tocilizumab: −0.04; control: 0.09; p = 0.636). Also, no difference in time to discharge was found between the two sub-cohorts (logrank test: p = 0.472). The logistic regression models, did not show an effect of tocilizumab on mortality (OR 0.99; p = 0.990). Conclusions: We did not find a clinical benefit associated with the use tocilizumab, in terms of respiratory function at 48 h of treatment, or time to discharge.