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Repurposed Tocilizumab in Patients with Severe COVID-19
- Source :
- J Immunol
- Publication Year :
- 2021
- Publisher :
- The American Association of Immunologists, 2021.
-
Abstract
- The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable morbidity and mortality. Tocilizumab, an inhibitor of IL-6, has been widely repurposed as a treatment of severely ill patients without robust evidence supporting its use. In this study, we aimed to systematically describe the effectiveness of treatment and prevention of the cytokine storms in COVID-19 patients with tocilizumab. In this multicentered retrospective and observational cohort study, 65 patients with COVID-19 receiving tocilizumab and 130 not receiving tocilizumab were propensity score matched at a ratio of 2:1 based on age, sex, and comorbidities from January 20, 2020 to March 18, 2020 in Wuhan, China. After adjusting for confounding, the detected risk for in-hospital death was lower in the tocilizumab group versus nontocilizumab group (hazard ratio = 0.47; 95% confidence interval = 0.25–0.90; p = 0.023). Moreover, use of tocilizumab was associated with a lower risk of acute respiratory distress syndrome (odds ratio = 0.23; 95% confidence interval = 0.11–0.45; p < 0.0001). Furthermore, patients had heightened inflammation and more dysregulated immune cells before treatment, which might aggravate disease progression. After tocilizumab administration, abnormally elevated IL-6, C-reactive protein, fibrinogen, and activated partial thromboplastin time decreased. Tocilizumab may be of value in prolonging survival in patients with severe COVID-19, which provided a novel strategy for COVID-19–induced cytokine release syndrome. Our findings could inform bedside decisions until data from randomized, controlled clinical trials become available.
- Subjects :
- Male
musculoskeletal diseases
medicine.medical_specialty
Infectious Disease and Host Response
Immunology
Antibodies, Monoclonal, Humanized
Lower risk
Severity of Illness Index
Cohort Studies
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Tocilizumab
Internal medicine
medicine
Humans
Immunology and Allergy
Aged
Retrospective Studies
Respiratory Distress Syndrome
medicine.diagnostic_test
Interleukin-6
SARS-CoV-2
business.industry
Hazard ratio
Drug Repositioning
COVID-19
Odds ratio
Middle Aged
medicine.disease
COVID-19 Drug Treatment
Cytokine release syndrome
chemistry
Propensity score matching
Female
Cytokine Release Syndrome
business
030215 immunology
Cohort study
Partial thromboplastin time
Subjects
Details
- ISSN :
- 15506606 and 00221767
- Volume :
- 206
- Database :
- OpenAIRE
- Journal :
- The Journal of Immunology
- Accession number :
- edsair.doi.dedup.....b6e1e7c8843bedf8ff4c25bf7944e290