First Report of Tocilizumab Use in a Cohort of Latin American Patients Hospitalized for Severe COVID-19 Pneumonia

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dc.contributor.authorValenzuela, Omar
dc.contributor.authorIbáñez, Sebastián
dc.contributor.authorPoli, Cecilia
dc.contributor.authorRoessler, Patricia
dc.contributor.authorAylwin, Mabel
dc.contributor.authorRoizen, Gigia
dc.contributor.authorIruretagoyena, Mirentxu
dc.contributor.authorAgar, Vivianne
dc.contributor.authorDonoso, Javiera
dc.contributor.authorFierro, Margarita
dc.contributor.authorMontes, José
dc.date.accessioned2021-07-14T18:09:24Z
dc.date.available2021-07-14T18:09:24Z
dc.date.issued2020
dc.description.abstractIntroduction/objectives: An interleukin-6 inhibition strategy could be effective in selected COVID-19 patients. The objective is to present our experience of tocilizumab use in patients with severe COVID-19. Methods: Observational retrospective cohort study. Hospitalized patients were evaluated by our multidisciplinary team for eventual use of tocilizumab. Patients with progressive ventilatory impairment and evidence of a hyperinflammatory state despite usual treatment received tocilizumab 8 mg/kg intravenous (maximum dose 800 mg), in addition to standard treatment. The use and time of use of mechanical ventilation (MV), the change of the Alveolar-arterial (A-a) gradient, of the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) and of inflammation laboratory parameters after 72 h of tocilizumab use was evaluated. Results: 29 patients received tocilizumab. 93.1% were men, 37.9% were obese, and 34.5% had hypertension. Of the 20 patients who were not on MV when receiving tocilizumab, 11 required non-invasive MV, for an average of 5 days, and one of them required intubation. A-a gradient, PaO2/FiO2, and inflammation parameters improved significantly. A better lymphocyte count, which improved significantly after tocilizumab use, was significantly associated with less use of MV. Five patients presented positive culture samples after tocilizumab, three being of clinical significance. A lower lymphocyte count was associated with having a positive culture. No other significant adverse events were seen. Conclusion: Our study suggests the utility and shows the safety of tocilizumab use in COVID-19 patients who have respiratory failure and evidence of hyperinflammation. Lymphocyte improvement was a predictor of good response.es
dc.identifier.citationFrontiers in Medicine, 2020, vol.7, art.596916es
dc.identifier.urihttps://doi.org/10.3389/fmed.2020.596916es
dc.identifier.urihttp://hdl.handle.net/11447/4184
dc.language.isoenes
dc.subjectCOVID-19es
dc.subjectSARS-CoV 2es
dc.subjectLymphocytees
dc.subjectMechanical ventilaliones
dc.subjectTocilizumabes
dc.titleFirst Report of Tocilizumab Use in a Cohort of Latin American Patients Hospitalized for Severe COVID-19 Pneumoniaes
dc.typeArticlees

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