Early administration of interleukin-6 inhibitors for patients with severe COVID-19 disease is associated with decreased intubation, reduced mortality, and increased discharge.
Antibodies, Monoclonal, Humanized
/ therapeutic use
Betacoronavirus
COVID-19
Coronavirus Infections
/ drug therapy
Female
Humans
Interleukin-6
/ antagonists & inhibitors
Intubation, Intratracheal
Male
Middle Aged
Pandemics
Patient Discharge
Pneumonia, Viral
/ drug therapy
SARS-CoV-2
Treatment Outcome
COVID-19
Cytokine release syndrome
Interleukin-6 inhibitors
Sarilumab
Tocilizumab
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
08
07
2020
revised:
16
07
2020
accepted:
18
07
2020
pubmed:
30
7
2020
medline:
24
10
2020
entrez:
30
7
2020
Statut:
ppublish
Résumé
The aim of this observational study was to determine the optimal timing of interleukin-6 receptor inhibitor (IL6ri) administration for coronavirus disease 2019 (COVID-19). Patients with COVID-19 were given an IL6ri (sarilumab or tocilizumab) based on iteratively reviewed guidelines. IL6ri were initially reserved for critically ill patients, but after review, treatment was liberalized to patients with lower oxygen requirements. Patients were divided into two groups: those requiring ≤45% fraction of inspired oxygen (FiO A total of 255 COVID-19 patients were treated with IL6ri (149 stage IIB and 106 stage III). Patients treated in stage IIB had lower mortality than those treated in stage III (adjusted hazard ratio (aHR) 0.24, 95% confidence interval (CI) 0.08-0.74). Overall, 218 (85.5%) patients were discharged alive. Patients treated in stage IIB were more likely to be discharged (aHR 1.43, 95% CI 1.06-1.93) and were less likely to be intubated (aHR 0.43, 95% CI 0.24-0.79). IL6ri administration prior to >45% FiO
Identifiants
pubmed: 32721528
pii: S1201-9712(20)30568-3
doi: 10.1016/j.ijid.2020.07.023
pmc: PMC7591937
mid: NIHMS1638441
pii:
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Interleukin-6
0
tocilizumab
I031V2H011
sarilumab
NU90V55F8I
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
28-33Subventions
Organisme : NIAID NIH HHS
ID : K24 AI145661
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI042853
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG060890
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI052074
Pays : United States
Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
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