Objective The aim of this retrospective observational study is to analyse clinical, serological and radiological predictors of outcome in patients with COVID-19 pneumonia treated with tocilizumab, providing clinical guidance to its use in real-life. Method This is a retrospective, monocentric observational cohort study. All consecutive patients hospitalized between February the 11 th and April 14 th 2020 for severe COVID-19 pneumonia at Reggio Emilia AUSL and treated with tocilizumab were enrolled. The patient’s clinical status was recorded every day using the WHO ordinal scale for clinical improvement. Response to treatment was defined as an improvement of one point (from the status at the beginning of tocilizumab treatment) during the follow-up on this scale. Bivariate association of main patients’ characteristics with outcomes was explored by descriptive statistics and Fisher or Kruskal Wallis tests (respectively for qualitative or quantitative variables). Each clinically significant predictor was checked by a loglikelihood ratio test (in univariate logistic models for each of the considered outcomes) against the null model. Results A total of 173 patients were included. Only hypertension, the use of angiotensin-converting enzyme inhibitors, PaO 2 /FiO 2 , respiratory rate and C-reactive protein were selected for the multivariate analysis. In the multivariable model, none of them was significantly associated with response. Conclusions Evaluating a large number of clinical variables, our study did not find new predictors of outcome in COVID19 patients treated with tocilizumab. Further studies are needed to investigate the use of tocilizumab in COVID-19 and to better identify clinical phenotypes which could benefit from this treatment.
【초록키워드】 COVID-19, Treatment, Severe COVID-19 pneumonia, COVID-19 pneumonia, Hospitalized, Tocilizumab, Pneumonia, C-reactive protein, outcome, hypertension, inhibitors, observational study, clinical status, outcomes, Characteristics, angiotensin-converting enzyme inhibitors, Patient, Clinical improvement, Follow-up, predictor, serological, Guidance, association, clinical phenotype, Angiotensin-converting enzyme, Multivariate analysis, Ordinal Scale, retrospective, Analysis, angiotensin, respiratory rate, response to treatment, Observational cohort study, Logistic, clinical variables, status, clinical phenotypes, Descriptive statistics, WHO ordinal scale, multivariable model, quantitative variables, Fisher, COVID19 patients, objective, benefit, radiological, null model, Result, enrolled, selected, defined, identify, significantly, clinically, treated, the WHO, checked, consecutive patient, COVID19 patient, Evaluating, PaO, patients with COVID-19, was recorded, 【제목키워드】 Clinical outcome, Retrospective analysis, Factor, treated, patients with COVID-19,