Predictive factors of mortality in patients treated with tocilizumab for acute respiratory distress syndrome related to coronavirus disease 2019 (COVID-19)

COVID-19 patients (n = 34) suffering from ARDS were treated with tocilizumab (TCZ). Outcome was classified in two groups: “Death” and “Recovery”. Predictive factors of mortality were studied. Mean age was 75.3, mean oxygen (O2) requirements 10.4 l/min. At baseline, all patients had multiple biologic...

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Published in:Microbes and infection 2020-10, Vol.22 (9), p.500-503
Main Authors: Lohse, Anne, Klopfenstein, Timothée, Balblanc, Jean-Charles, Royer, Pierre-Yves, Bossert, Marie, Gendrin, Vincent, Charpentier, Aline, Bozgan, Ana-Maria, Badie, Julio, Bourgoin, Charlotte, Contreras, Remy, Mazurier, Isabelle, Conrozier, Thierry, Zayet, Souheil
Format: Article
Language:English
Subjects:
Acute respiratory distress syndrome
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Antibodies, Monoclonal, Humanized - therapeutic use
Anticoagulants - therapeutic use
Aspartate Aminotransferases - blood
Betacoronavirus - drug effects
Betacoronavirus - pathogenicity
Biomarkers
Biomarkers - blood
C-Reactive Protein - metabolism
Coronavirus Infections - diagnosis
Coronavirus Infections - drug therapy
Coronavirus Infections - mortality
Coronavirus Infections - virology
COVID-19
Female
Fibrin Fibrinogen Degradation Products - metabolism
Fibrinogen - metabolism
Humans
Hydroxychloroquine - therapeutic use
Lymphopenia - diagnosis
Lymphopenia - drug therapy
Lymphopenia - mortality
Lymphopenia - virology
Male
Pandemics
Pneumonia, Viral - diagnosis
Pneumonia, Viral - drug therapy
Pneumonia, Viral - mortality
Pneumonia, Viral - virology
Predictive factors
Prognosis
Respiratory Distress Syndrome - diagnosis
Respiratory Distress Syndrome - drug therapy
Respiratory Distress Syndrome - mortality
Respiratory Distress Syndrome - virology
Retrospective Studies
SARS-CoV-2
Short Communication
Survival Analysis
Thrombocytopenia - diagnosis
Thrombocytopenia - drug therapy
Thrombocytopenia - mortality
Thrombocytopenia - virology
Tocilizumab
Tomography, X-Ray Computed
Treatment Outcome
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Summary:COVID-19 patients (n = 34) suffering from ARDS were treated with tocilizumab (TCZ). Outcome was classified in two groups: “Death” and “Recovery”. Predictive factors of mortality were studied. Mean age was 75.3, mean oxygen (O2) requirements 10.4 l/min. At baseline, all patients had multiple biological abnormalities (lymphopenia, increased CRP, ferritin, fibrinogen, D-dimer and liver enzymes). 24 patients (70.5%) recovered after TCZ therapy and 10 died (29.5%). Deceased subjects differed from patients in whom treatment was effective with regard to more pronounced lymphopenia (0.6 vs 1.0 G/l; p = 0.037), lower platelet number (156 vs 314 G/l; p = 0.0001), lower fibrinogen serum level (0.6 vs 1.0 G/l; p = 0.03), higher aspartate-amino-transferase (108 vs 57 UI/l; p = 0.05) and greater O2 requirements (11 vs 8 l/min; p = 0.003).
ISSN:1286-4579
1769-714X
DOI:10.1016/j.micinf.2020.06.005