About: Tocilizumab in patients with severe COVID-19: a retrospective cohort study

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Tocilizumab in patients with severe COVID-19: a retrospective cohort study
Creator	Clini, Enrico Fantini, Riccardo Cossarizza, Andrea Massari, Marco Cozzi-Lepri, Alessandro Borghi, Vanni Bartoletti, Michele Salvarani, Carlo Brugioni, Lucio Dolci, Giovanni Giannella, Maddalena Girardis, Massimo Guaraldi, Giovanni Menozzi, Marianna Meschiari, Marianna Mussini, Cristina Pascale, Renato Pea, Federico Pietrangelo, Antonello Tedeschi, Sara Tonelli, Roberto Bedini, Andrea Carli, Federica Corradi, Luca Cuomo, Gianluca Franceschini, Erica Milic, Jovana Orlando, Gabriella Santoro, Antonella Castaniere, Ivana Clini, E Puzzolante, Cinzia Tabbì, Luca Viale, Pier Brugioni, L Cozzi-Lepri, A Fantini, R Gaetano, Margherita Girardis, M Medicine, Experimental Milic, J Program, Phd Tabbì, L Tonelli, ( Tonelli, R
source	Elsevier; Medline; PMC
abstract	BACKGROUND: No therapy is approved for COVID-19 pneumonia. The aim of this study was to assess the role of tocilizumab in reducing the risk of invasive mechanical ventilation and death in patients with severe COVID-19 pneumonia who received standard of care treatment. METHODS: This retrospective, observational cohort study included adults (≥18 years) with severe COVID-19 pneumonia who were admitted to tertiary care centres in Bologna and Reggio Emilia, Italy, between Feb 21 and March 24, 2020, and a tertiary care centre in Modena, Italy, between Feb 21 and April 30, 2020. All patients were treated with the standard of care (ie, supplemental oxygen, hydroxychloroquine, azithromycin, antiretrovirals, and low molecular weight heparin), and a non-randomly selected subset of patients also received tocilizumab. Tocilizumab was given either intravenously at 8 mg/kg bodyweight (up to a maximum of 800 mg) in two infusions, 12 h apart, or subcutaneously at 162 mg administered in two simultaneous doses, one in each thigh (ie, 324 mg in total), when the intravenous formulation was unavailable. The primary endpoint was a composite of invasive mechanical ventilation or death. Treatment groups were compared using Kaplan-Meier curves and Cox regression analysis after adjusting for sex, age, recruiting centre, duration of symptoms, and baseline Sequential Organ Failure Assessment (SOFA) score. FINDINGS: Of 1351 patients admitted, 544 (40%) had severe COVID-19 pneumonia and were included in the study. 57 (16%) of 365 patients in the standard care group needed mechanical ventilation, compared with 33 (18%) of 179 patients treated with tocilizumab (p=0·41; 16 [18%] of 88 patients treated intravenously and 17 [19%] of 91 patients treated subcutaneously). 73 (20%) patients in the standard care group died, compared with 13 (7%; p<0·0001) patients treated with tocilizumab (six [7%] treated intravenously and seven [8%] treated subcutaneously). After adjustment for sex, age, recruiting centre, duration of symptoms, and SOFA score, tocilizumab treatment was associated with a reduced risk of invasive mechanical ventilation or death (adjusted hazard ratio 0·61, 95% CI 0·40–0·92; p=0·020). 24 (13%) of 179 patients treated with tocilizumab were diagnosed with new infections, versus 14 (4%) of 365 patients treated with standard of care alone (p<0·0001). INTERPRETATION: Treatment with tocilizumab, whether administered intravenously or subcutaneously, might reduce the risk of invasive mechanical ventilation or death in patients with severe COVID-19 pneumonia. FUNDING: None.
has issue date	2020-06-24(xsd:dateTime)
bibo:doi	10.1016/s2665-9913(20)30173-9
bibo:pmid	32835257
has license	no-cc
sha1sum (hex)	484b197e593a29d88b63837f228d3cc3df55ebc1
schema:url	https://doi.org/10.1016/s2665-9913%2820%2930173-9
resource representing a document's title	Tocilizumab in patients with severe COVID-19: a retrospective cohort study
has PubMed Central identifier	PMC7314456
has PubMed identifier	32835257
schema:publication	Lancet Rheumatol
resource representing a document's body	covid:484b197e593a29d88b63837f228d3cc3df55ebc1#body_text
is schema:about of	named entity 'COVID-19' named entity 'COVID-19' named entity 'ROLE' named entity 'TREATMENT' named entity 'RECEIVED' named entity 'COVID-19' named entity 'Background' named entity 'patients' named entity 'risk' named entity 'aim' named entity 'Tocilizumab' named entity 'invasive mechanical ventilation' named entity 'pneumonia' named entity 'COVID-19' named entity 'COVID-19' named entity 'pneumonia' named entity 'cytokine storm' named entity 'inflammatory bowel disease' named entity 'intravenous' named entity 'Charlson Comorbidity Index' named entity 'urinary tract infection' named entity 'invasive mechanical ventilation' named entity 'Italy' named entity 'IL-6 receptor' named entity 'Hubei' named entity 'cytokine storm' named entity 'Tocilizumab' named entity 'Cary, NC' named entity 'Kaplan-Meier' named entity 'COVID-19' named entity 'tocilizumab' named entity 'standard of care' named entity 'tocilizumab' named entity 'invasive mechanical ventilation' named entity '95% CI' named entity 'tocilizumab' named entity 'mechanical ventilation'

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