Laboratory parameters predicting mortality of adult in-patients with COVID-19 associated cytokine release syndrome treated with high-dose tocilizumab.
Botond Lakatos,Balint Gergely Szabo,Ilona Bobek,László Gopcsa,Gabriella Beko,Noemi Kiss-Dala,Borisz Petrik,Zsofia Gaspar,Balazs Ferenc Farkas,János Sinkó,Péter Reményi,János Szlávik,István Vályi-Nagy +12 more
TLDR
In this article, the authors evaluated high-dose (8 mg/kg) intravenous tocilizumab administration in severe and critically ill COVID-19 adult patients fulfilling predefined strict CRS criteria.Abstract:
Large randomized clinical trials in severe Coronavirus Disease 2019 (COVID-19) patients have proven efficacy of intravenous tocilizumab. Our aim was to describe the laboratory parameters predicting in-hospital mortality of patients with tocilizumab administration in COVID-19 associated cytokine release syndrome (CRS).We evaluated high-dose (8 mg/kg) intravenous tocilizumab administration in severe and critically ill COVID-19 adult patients fulfilling predefined strict CRS criteria. A single-centre, prospective, observational cohort study was carried out among consecutive adult (≥18 years of age) in-patients with COVID-19 between April 1 and December 31, 2020. The primary endpoint was 28-day all-cause mortality. The changes in laboratory parameters from baseline on day 7 and 14 after administration of tocilizumab were analysed.In total, 1801 patients were admitted to our centre during the study period. One hundred and six patients received tocilizumab, and among them 62 (58.5%) required intensive care unit admittance while 25 (23.6%) deceased. At day 7 after tocilizumab administration, inflammatory markers (CRP, IL-6, ferritin) and lactate dehydrogenase (LDH) values were significantly lower among survivors. Subsequently, at day 14, differences of IL-6 and LDH levels has become more pronounced between subgroups. Restoration of absolute lymphocyte count (ALC) by day 7 and 14 was insufficient among patients who died.In our cohort, administration of high-dose tocilizumab for COVID-19 patients with CRS demonstrated clinical and sustained biochemical parameter improvement in 76.4%. In this patient population high and increasing LDH, IL-6, and low ALC levels had a predictive role for mortality.read more
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Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study.
Ohoud Aljuhani,Khalid Al Sulaiman,Khalid Al Sulaiman,Adel Alshabasy,Adel Alshabasy,Khalid Eljaaly,Khalid Eljaaly,Abdulrahman Al Shaya,Abdulrahman Al Shaya,Haytham Noureldeen,Haytham Noureldeen,Mohammed Aboudeif,Bodoor Al Dosari,Amina Alkhalaf,Ghazwa B. Korayem,Muneera M. Aleissa,Muneera M. Aleissa,Hisham A. Badreldin,Hisham A. Badreldin,Shmeylan Al Harbi,Shmeylan Al Harbi,Abdullah M Alhammad,Ramesh Vishwakarma +22 more
TL;DR: In this paper, a multicenter retrospective cohort study was conducted at two tertiary government hospitals in Saudi Arabia to determine the association between tocilizumab treatment and microbial isolation and emergence of multidrug-resistant bacteria in critically ill patients with COVID-19.
Journal ArticleDOI
Common points of therapeutic intervention in COVID-19 and in allogeneic hematopoietic stem cell transplantation associated severe cytokine release syndrome.
László Gopcsa,Ilona Bobek,Gabriella Bekő,Botond Lakatos,Eszter Molnár,Marienn Réti,Péter Reményi,János Sinkó,János Szlávik,Gábor Tatai,István Vályi-Nagy +10 more
TL;DR: In this article, the authors compared clinical and laboratory co-variates as well as response to tocilizumab (TCZ)-based therapy of 15 allogeneic-HSCT- and 17 COVID-19-associated sCRS patients.
Journal ArticleDOI
Factors predicting poor outcomes of patients treated with tocilizumab for COVID‑19‑associated pneumonia: A retrospective study
Vasiliki E Georgakopoulou,Dimitrios Basoulis,P. M. Voutsinas,Sotiria Makrodimitri,Stamatia Samara,Maria Triantafyllou,Irene Eliadi,Georgios Karamanakos,Chrysovalantis V. Papageorgiou,Amalia Anastasopoulou,Aikaterini Bitsani,Olga Kampouropoulou,Ioanna Eleftheriadou,Aikaterini Gkoufa,Demetrios A. Spandidos,Petros Papalexis,Nikolaos V. Sipsas +16 more
TL;DR: The data of the present study may be used to identify patient subpopulations responding to treatment with tocilizumab in prospective clinical trials, as well as to identify predictors of mortality and other unfavorable outcomes in patients treated for COVID‑19‑associated pneumonia.
Journal ArticleDOI
Predictors of poor outcome in tocilizumab treated patients with Sars-CoV-2 related severe respiratory failure: A multicentre real world study
Luca Masotti,Giancarlo Landini,Grazia Panigada,Elisa Grifoni,Roberto Tarquini,Francesco Cei,Barbara Maria Angela Cimolato,Vieri Vannucchi,M. Di Pietro,F. Piani,Alberto Fortini,Antonio Faraone,Gabriele Nenci,F Cipollini,Pierluigi Blanc,Pamela Lotti,Massimo Edoardo Di Natale,Filippo Risaliti,D. Aquilini,Cristiana Seravalle,Andrea Bribani,A. Farsi,Irene Micheletti,Elisabetta Cioni,G. Pelagalli,Chiara Mattaliano,Gabriele Pinto,Elisa Maria Madonia,Irene Sivieri,Marianna Mannini,Alice Valoriani,Simona Brancati,M. Rosselli,E Pavone,Maria Chiara Burla,Alessandro Sergi +35 more
TL;DR: In this article , a multicentre study focusing on Tocilizumab treated severe COVID-19 patients, age ≥ 65 years, procalcitonin ≥ 0.14 ng/mL, RAO2S ≤ 90% and CCT-GGO involvement ≥ 50% were independent risk factors associated with poor outcome.
Journal ArticleDOI
Clinical Predictors of Response to Tocilizumab: A Retrospective Multicenter Study
TL;DR: In this paper , the clinical predictors of mortality for critically ill COVID-19 patients receiving tocilizumab therapy were evaluated, including advanced age, increased leukocyte count, higher CALL and GRAM scores, and the need for invasive mechanical ventilation.
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TL;DR: T cell counts are reduced significantly in COVID-19 patients, and the surviving T cells appear functionally exhausted, and non-ICU patients with total T cells counts lower than 800/μL may still require urgent intervention, even in the immediate absence of more severe symptoms.
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