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Early use of tocilizumab in patients with severe pneumonia secondary to severe acute respiratory syndrome coronavirus 2 infection and poor prognostic criteria: Impact on mortality rate and intensive care unit admission.

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2021

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Sánchez-Rovira, Pedro
Pérez-Chica, Gerardo
Ortega-Granados, Ana Laura
Aguilar-García, Josefa
Díaz-Beltrán, Leticia
Gálvez-Montosa, Fernando
García-Verdejo, Francisco
Luque-Caro, Natalia
Quero-Blanco, Cristina
Fernández-Navarro, Mónica

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The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, keeps spreading globally. Evidence suggests that a subgroup of patients with severe symptomatology might have cytokine storms, which increases mortality. The use of interleukin-6 (IL-6) inhibitors may help in controlling the pathological immune response to the virus. Tocilizumab, a monoclonal antibody against IL-6, stands as an optional treatment for COVID-19 patients presenting this inflammatory hyper-response.We conducted a retrospective, observational, cohort study including 50 patients affected by COVID-19 with severe pneumonia and poor prognosis criteria, who have also undergone standard treatment; 36 of these patients additionally received tocilizumab in an early stage. The need for intensive care unit (ICU) admission, mortality, recovery of respiratory function, and improvement of biochemical and hematological parameters were compared between cohorts.Most patients were men, non-smokers and the most frequently reported comorbidities were hypertension and diabetes. Recurrent symptoms were fever, cough, and dyspnoea. 54.8% of patients from the tocilizumab group needed intubation, while in the control group 85.7% needed it. Treatment with tocilizumab significatively increased IL-6 levels, (554.45; CI 95% 186.69, 1032.93; P 

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Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal, Humanized
COVID-19
Female
Humans
Intensive Care Units
Interleukin-6
Male
Middle Aged
Pneumonia, Viral
Prognosis
Retrospective Studies
COVID-19 Drug Treatment

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