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

Journal volume & issue
Vol. 12
p. 100214

Abstract

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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.

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