%0 Journal Article
%A Ruiz-Antorán, Belén
%A Sancho-López, Aránzazu
%A Torres, Ferrán
%A Moreno-Torres, Víctor
%A de Pablo-López, Itziar
%A García-López, Paulina
%A Abad-Santos, Francisco
%A Rosso-Fernández, Clara M
%A Aldea-Perona, Ana
%A Montané, Eva
%A Aparicio-Hernández, Ruth M
%A Llop-Rius, Roser
%A Pedrós, Consuelo
%A Gijón, Paloma
%A Hernández-Carballo, Carolina
%A Pedrosa-Martínez, María J
%A Rodríguez-Jiménez, Consuelo
%A Prada-Ramallal, Guillermo
%A Cabrera-García, Lourdes
%A Aguilar-García, Josefa A
%A Sanjuan-Jimenez, Rocío
%A Ortiz-Barraza, Evelyn I
%A Sánchez-Chica, Enrique
%A Fernández-Cruz, Ana
%A TOCICOV-study group
%T Combination of Tocilizumab and Steroids to Improve Mortality in Patients with Severe COVID-19 Infection: A Spanish, Multicenter, Cohort Study.
%D 2020
%@ 2193-8229
%U https://hdl.handle.net/10668/26780
%X We aimed to determine the impact of tocilizumab use on severe COVID-19 (coronavirus disease 19) pneumonia mortality. We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocilizumab were compared to patients not treated with tocilizumab, adjusting by inverse probability of the treatment weights (IPTW). Tocilizumab's effect in patients receiving steroids during the 48 h following inclusion was analysed. During the study period, 506 patients with severe COVID-19 fulfilled the inclusion criteria. Among them, 268 were treated with tocilizumab and 238 patients were not. Median time to tocilizumab treatment from onset of symptoms was 11 days [interquartile range (IQR) 8-14]. Global mortality was 23.7%. Mortality was lower in patients treated with tocilizumab than in controls: 16.8% versus 31.5%, hazard ratio (HR) 0.514 [95% confidence interval (95% CI) 0.355-0.744], p  These results show that survival of patients with severe COVID-19 is higher in those treated with tocilizumab than in those not treated and that tocilizumab's effect adds to that of steroids administered to non-intubated patients with COVID-19 during the first 48 h of presenting with respiratory failure despite oxygen therapy. Randomised controlled studies are needed to confirm these results. European Union electronic Register of Post-Authorization Studies (EU PAS Register) identifier, EUPAS34415.
%K COVID-19
%K Mortality
%K SARS-CoV-2
%K Steroids
%K Tocilizumab
%~