To access the full text documents, please follow this link: http://hdl.handle.net/20.500.12328/1846

Title:	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
Notes:	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.
Subject(s):	-Esteroides -Corticosteroides -COVID-19 (Malaltia) -Mortalitat -Esteroides -Corticosteroides -COVID-19 -Mortalidad -Steroids -Corticosteroids -COVID-19 -Mortality -61 -616.9
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/). https://creativecommons.org/licenses/by-nc-nd/4.0/
Document type:	Article Article - Published version
Published by:	International Journal of Infectious Diseases
Share:

Show full item record