Tocilizumab therapy reduced intensive care unit admissions and/or mortality in COVID-19 patients
Tocilizumab therapy reduced intensive care unit admissions and/or mortality in COVID-19 patients
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DOI：
10.1016/j.medmal.2020.05.001
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发表时间：
2020-08-01
影响因子：
5
通讯作者：
Conrozier, T.
中科院分区：
文献类型：
--
作者：
Klopfenstein, T.;Zayet, S.;Conrozier, T.
导言。-目前还没有疗法被证明对新冠肺炎有效。托西珠单抗治疗重症新冠肺炎可能是一种有效的治疗方法。-我们在法国北弗兰奇-孔德医院进行了一项回溯性病例对照研究。我们比较了接受TCZ治疗的患者和没有接受TCZ治疗的患者的结果，考虑到合并的主要终点：死亡和/或ICU入院。-TCZ患者(n=20)的Charlson共病指数较高(5.3vs3.4[+/-2.6vs3.4[+/-2.6vs3.4]，P=0.014)，表现为更严重的形式(氧疗水平为13 L/分钟vs6 L/分钟，P<；0.001)，生物学指标(严重淋巴细胞减少：676/mm(3)vs914/mm(3)，P=0.037)和较高的C反应蛋白水平：158 mg/L vs105 mg/L，P=0.017)。然而，未使用TCZ的患者的死亡率和/或ICU住院率高于TCZ组(72%比25%，P=0.002)。-尽管这项工作的样本量和回溯性很小，但这一结果强烈表明，TCZ可能会减少重症SARS-CoV-2肺炎患者的ICU入院次数和/或死亡率。(C)2020年爱思唯尔·马森公司。版权所有。
Introduction. - No therapy has yet proven effective in COVID-19. Tocilizumab (TCZ) in patients with severe COVID-19 could be an effective treatment.Method. - We conducted a retrospective case-control study in the Nord Franche-Comte Hospital, France. We compared the outcome of patients treated with TCZ and patients without TCZ considering a combined primary endpoint: death and/or ICU admissions.Results. - Patients with TCZ (n = 20) had a higher Charlson comorbidity index (5.3 [+/- 2.4] vs 3.4 [+/- 2.6], P = 0.014), presented with more severe forms (higher level of oxygen therapy at 13 L/min vs 6 L/min, P< 0.001), and had poorer biological findings (severe lymphopenia: 676/mm(3) vs 914/mm(3), P= 0.037 and higher CRP level: 158 mg/L vs 105 mg/L, P = 0.017) than patients without TCZ (n = 25). However, death and/or ICU admissions were higher in patients without TCZ than in the TCZ group (72% vs 25%, P= 0.002).Conclusion. - Despite the small sample size and retrospective nature of the work, this result strongly suggests that TCZ may reduce the number of ICU admissions and/or mortality in patients with severe SARS-CoV-2 pneumonia. (C) 2020 Elsevier Masson SAS. All rights reserved.