Tocilizumab (TCZ) and Dexamethasone are used for the treatment of critically ill COVID-19 patients. We compared the short-term survival of critically ill COVID-19 patients treated with either TCZ or Dexamethasone. 109 critically ill COVID-19 patients randomly assigned to either TCZ therapy (46 patients) or pulse Dexamethasone therapy (63 patients). Age, sex, neutrophil/ lymphocyte ratio, D-dimer, ferritin level, and CT chest pattern were comparable between groups. Kaplan–Meier survival analysis showed better survival in Dexamethasone group compared with TCZ ( P = 0.002), patients didn’t need vasopressor at admission ( P < 0.0001), patients on non-invasive ventilation compared to patients on mechanical ventilation ( P<0.0001 ), and in patients with ground glass pattern in CT chest ( P<0.0001 ) compared with those who have consolidation. Cox regression analysis showed that, TCZ therapy (HR = 2.162, 95% CI, 1.144–4.087, P <0.0001) compared with Dexamethasone group, higher neutrophil/Lymphocyte ratio (HR = 2.40, CI, 1.351–4.185, P = 0.003), lower PaO 2 /FiO 2 , 2 days after treatment, (HR = 1.147, 95% CI, 1.002–1.624, P < 0.0001) independently predicted higher probability of mortality. Dexamethasone showed better survival in severe COVID-19 compared to TCZ. Considering the risk factors mentioned here is crucial when dealing with severe COVID-19 cases. Clinical trial registration No clinicalTrials.gov: Nal protocol approved by Hospital Authorities, for data collection and for participation in CT04519385 (19/08/2020).
【초록키워드】 Dexamethasone, Treatment, therapy, Risk factors, Mortality, severe COVID-19, mechanical ventilation, Tocilizumab, neutrophil, Sex, D-dimer, ferritin, risk factor, Probability, lymphocyte, survival, Participation, Critically ill, clinical, Patient, non-invasive ventilation, Admission, consolidation, patients, COVID-19 patients, Data collection, survival analysis, COVID-19 patient, critically ill COVID-19 patients, Vasopressor, Trial registration, 95% CI, Cox regression analysis, CT chest, CT chest pattern, ground glass pattern, Kaplan–Meier survival analysis, Nal protocol, neutrophil/ lymphocyte ratio, short-term survival, pulse, Randomly, predicted, approved, treated, comparable, assigned, groups, on mechanical ventilation, PaO, TCZ, 【제목키워드】 COVID-19, survival, Patient, short term, assisted ventilation, treated,