دورية أكاديمية
Effect of Tocilizumab on "Ventilator Free Days" Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis.
| العنوان: | Effect of Tocilizumab on "Ventilator Free Days" Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis. |
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| المؤلفون: | Mady AF; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.; Anaesthesia Department, Faculty of Medicine, Tanta University, Tanta, Egypt., Abdulrahman B; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Mumtaz SA; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Al-Odat MA; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Kuhail A; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Altoraifi R; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Alshae R; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Alharthy AM; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Karakitsos D; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.; Department of Medicine, South Carolina University School of Medicine, Columbia, SC, USA.; Critical Care Department, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Aletreby WT; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia. |
| المصدر: | Romanian journal of anaesthesia and intensive care [Rom J Anaesth Intensive Care] 2023 Jan 14; Vol. 29 (1), pp. 1-7. Date of Electronic Publication: 2023 Jan 14 (Print Publication: 2022). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sciendo Country of Publication: Romania NLM ID: 101681752 Publication Model: eCollection Cited Medium: Print ISSN: 2392-7518 (Print) Linking ISSN: 23927518 NLM ISO Abbreviation: Rom J Anaesth Intensive Care Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: <2018>- : Warsaw, Poland : Sciendo Original Publication: Cluj-Napoca : Clusium, [2014]- |
| مستخلص: | Background: SARS-CoV-2 infection demonstrates a wide range of severity. More severe cases demonstrate a cytokine storm with elevated serum interleukin-6, hence IL-6 receptor antibody tocilizumab was tried for the management of severe cases. Aims: Effect of tocilizumab on ventilator-free days among critically ill SARS-CoV-2 patients. Method: Retrospective propensity score matching study, comparing mechanically ventilated patients who received tocilizumab to a control group. Results: 29 patients in the intervention group were compared to 29 controls. Matched groups were similar. Ventilator-free days were more numerous in the intervention group (SHR 2.7, 95% CI: 1.2 - 6.3; p = 0.02), ICU mortality rate was not different (37.9% versus 62%, p = 0.1), actual ventilator-free periods were significantly longer in tocilizumab group (mean difference 4.7 days; p = 0.02). Sensitivity analysis showed a significantly lower hazard ratio of death in tocilizumab group (HR 0.49, 95% CI: 0.25 - 0.97; p = 0.04). There was no difference in positive cultures among groups (55.2% in tocilizumab group versus 34.5% in the control; p = 0.1). Conclusion: Tocilizumab may improve the composite outcome of ventilator-free days at day 28 among mechanically ventilated SARS-CoV-2 patients; it is associated with significantly longer actual ventilator-free periods, and insignificantly lower mortality and higher superinfection. (© 2022 Ahmed F. Mady et al., published by Sciendo.) |
| References: | N Engl J Med. 2021 Apr 22;384(16):1491-1502. (PMID: 33631065) J Med Virol. 2020 Oct;92(10):2042-2049. (PMID: 32369191) Crit Care. 2020 Sep 29;24(1):589. (PMID: 32993751) Lancet Rheumatol. 2020 Oct;2(10):e603-e612. (PMID: 32838323) Int J Infect Dis. 2020 Oct;99:491-495. (PMID: 32798660) Lancet Rheumatol. 2020 Aug;2(8):e474-e484. (PMID: 32835257) Clin Infect Dis. 2021 Jul 15;73(2):e445-e454. (PMID: 32651997) BMJ. 2021 Jan 20;372:n84. (PMID: 33472855) N Engl J Med. 2018 Mar 01;378(9):809-818. (PMID: 29490185) Intensive Care Med. 2013 May;39(5):847-56. (PMID: 23306584) Ann Med Surg (Lond). 2020 Dec;60:417-424. (PMID: 33169088) N Engl J Med. 2021 Apr 22;384(16):1503-1516. (PMID: 33631066) Am J Respir Crit Care Med. 2011 Sep 1;184(5):561-8. (PMID: 21562125) Am J Epidemiol. 2007 Mar 15;165(6):710-8. (PMID: 17182981) Lancet. 2020 Mar 28;395(10229):1054-1062. (PMID: 32171076) Chest. 1997 Jul;112(1):164-72. (PMID: 9228372) J Med Virol. 2020 Jul;92(7):814-818. (PMID: 32253759) Int J Antimicrob Agents. 2020 Sep;56(3):106103. (PMID: 32712333) J Intern Med. 2021 Mar;289(3):434-436. (PMID: 32744399) J Med Virol. 2020 Nov;92(11):2283-2285. (PMID: 32343429) J Thorac Oncol. 2020 May;15(5):700-704. (PMID: 32114094) Am J Respir Crit Care Med. 2019 Oct 1;200(7):828-836. (PMID: 31034248) |
| فهرسة مساهمة: | Keywords: SARS-CoV-2; tocilizumab; ventilator-free days |
| تواريخ الأحداث: | Date Created: 20230227 Latest Revision: 20230228 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC9949015 |
| DOI: | 10.2478/rjaic-2022-0001 |
| PMID: | 36844963 |
| قاعدة البيانات: | MEDLINE |
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