Abstract
Background : We report the long-term outcomes, changes in laboratory parameters, the incidence of secondary nosocomial infections and treatment cost of a Spanish cohort of patients with severe COVID-19 that received tocilizumab (TCZ). Methods : Retrospective cohort of PCR confirmed adult patients who received TCZ from March 1 to 24, 2020 in a tertiary hospital was analyzed. Patients were followed up until 10 May 2020. Results : We included 162 patients (median age 64 years; 70.4% male). At time of TCZ administration, 48.1% of patients were on invasive mechanical ventilation (IMV). Over a median follow-up of 53 days, 46.9% of patients were discharge in good conditions and 19.8% were still hospitalized. The overall mortality was 33.3%, being higher in patients on IMV than those who did not (46.2% vs 26.7%, P < 0.001). A significant improvement in the lymphocyte count, C-reactive protein, lactate dehydrogenase, and D-dimer was observed. Overall, 43.2% patients presented nosocomial infections, causing death in 8%. Infections were more prevalent in ICU units (63.0% vs 17.1%, P < 0.001). The total cost of TCZ was €371,784. Conclusions : Among the patients who used TCZ, one third died, regardless the improvement in some inflammatory biomarkers. The incidence of secondary nosocomial infections was high.
Keywords: COVID-19; SARS-CoV-2; Spain; mortality; tocilizumab.
【저자키워드】 COVID-19, SARS-CoV-2, Mortality, Tocilizumab, Spain, 【초록키워드】 Treatment, severe COVID-19, Tocilizumab, hospital, C-reactive protein, D-dimer, lactate dehydrogenase, discharge, ICU, outcomes, Lymphocyte count, Cohort, PCR, male, Patient, Nosocomial infection, death, Laboratory parameters, Follow-up, incidence, inflammatory biomarkers, Invasive mechanical ventilation, administration, Nosocomial infections, overall mortality, median age, over, Spanish, IMV, prevalent, Result, analyzed, died, the patient, median, condition, changes in, cohort of patient, still hospitalized, TCZ, 【제목키워드】 cohort study, clinical, Severe patient, Course, treated, with COVID-19,