• Int. J. Infect. Dis. · Jan 2021

    Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia.

    • Miguel Górgolas Hernández-Mora, Alfonso Cabello Úbeda, Laura Prieto-Pérez, Felipe Villar Álvarez, Beatriz Álvarez Álvarez, María Jesús Rodríguez Nieto, Irene Carrillo Acosta, Itziar Fernández Ormaechea, Aws Waleed Mohammed Al-Hayani, Pilar Carballosa, Silvia Calpena Martínez, Farah Ezzine, Marina Castellanos González, Alba Naya, Marta López De Las Heras, Marcel José Rodríguez Guzmán, Ana Cordero Guijarro, Antonio Broncano Lavado, Alicia Macías Valcayo, Marta Martín García, Javier Bécares Martínez, Fernández Roblas Ricardo R Department of Microbiology, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Spain., Miguel Ángel Piris Pinilla, José Fortes Alen, Olga Sánchez Pernaute, Fredeswinda Romero Bueno, Sarah Heili-Frades, and Germán Peces-Barba Romero.
    • Division of Infectious Diseases, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Spain.
    • Int. J. Infect. Dis. 2021 Jan 1; 102: 303-309.

    IntroductionTocilizumab (TCZ) is an interleukin-6 receptor antagonist, which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), which aims to ameliorate the cytokine release syndrome (CRS) induced acute respiratory distress syndrome (ARDS). However, there are no consistent data about who might benefit most from it.MethodsWe administered TCZ on a compassionate-use basis to patients with SSP who were hospitalized (excluding intensive care and intubated cases) and who required oxygen support to have a saturation >93%. The primary endpoint was intubation or death after 24 h of its administration. Patients received at least one dose of 400 mg intravenous TCZ from March 8, 2020 to April 20, 2020.ResultsA total of 207 patients were studied and 186 analyzed. The mean age was 65 years and 68% were male patients. A coexisting condition was present in 68% of cases. Prognostic factors of death were older age, higher IL-6, d-dimer and high-sensitivity C-reactive protein (HSCRP), lower total lymphocytes, and severe disease that requires additional oxygen support. The primary endpoint (intubation or death) was significantly worst (37% vs 13%, p < 0·001) in those receiving the drug when the oxygen support was high (FiO2 >0.5%).ConclusionsTCZ is well tolerated in patients with SSP, but it has a limited effect on the evolution of cases with high oxygen support needs.Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

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