The safety and effectiveness of tocilizumab in older adult critically ill patients with COVID-19: a multicenter, cohort study

被引:10
作者
Korayem, Ghazwa B. [1 ]
Aljuhani, Ohoud [3 ]
Altebainawi, Ali F. [4 ]
Al Shaya, Abdulrahman, I [5 ,6 ,7 ]
Alnajjar, Lina, I [1 ,2 ]
Alissa, Abdulrahman [2 ]
Aldhaeefi, Mohammed [5 ,6 ,7 ,13 ]
Kensara, Raed [6 ,7 ]
Al Muqati, Hessa [5 ]
Alhuwahmel, Abdulmohsen [7 ]
Alhuthaili, Omar [7 ]
Vishwakarma, Ramesh [8 ]
Aldardeer, Namareq [9 ]
Eljaaly, Khalid [3 ,11 ]
Alharbi, Aisha [12 ]
Al Harbi, Shmeylan [5 ,6 ,7 ]
Al Katheri, Abdulmalik [5 ,6 ,7 ]
Al Bekairy, Abdulkareem M. [5 ,6 ,7 ]
Aljedai, Ahmed [10 ]
Al Sulaiman, Khalid [5 ,6 ,7 ,14 ]
机构
[1] Princess Nourah Bint Abdulrahman Univ, Coll Pharm, Dept Pharm Practice, POB 84428, Riyadh 11671, Saudi Arabia
[2] King Abdullah Bin Abdulaziz Univ Hosp, Pharmaceut Care Serv, Riyadh, Saudi Arabia
[3] King Abdulaziz Univ, Fac Pharm, Dept Pharm Practice, Jeddah, Saudi Arabia
[4] Minist Hlth, Pharmaceut Care Serv, King Salman Specialist Hosp, Hail Hlth Cluster, Riyadh, Saudi Arabia
[5] King Abdul Aziz Med City, Pharmaceut Care Dept, Riyadh, Saudi Arabia
[6] King Abdullah Int Med Res Ctr, Riyadh, Saudi Arabia
[7] King Saud Bin Abdulaziz Univ Hlth Sci, Coll Pharm, Riyadh, Saudi Arabia
[8] European Org Res & Treatment Canc EORTC Headquart, Stat Dept, Brussels, Belgium
[9] King Faisal Specialist Hosp & Res Ctr, Pharmaceut Care Serv, Jeddah, Saudi Arabia
[10] Minist Hlth, Therapeut Affairs, Riyadh, Saudi Arabia
[11] Univ Arizona, Coll Pharm, Tucson, AZ 85721 USA
[12] King Abdulaziz Univ Hosp, Pharmaceut Care Dept, Jeddah, Saudi Arabia
[13] Howard Univ, Dept Clin & Adm Pharm Sci, Coll Pharm, Washington, DC 20059 USA
[14] Saudi Crit Care Pharm Res SCAPE Platform, Riyadh, Saudi Arabia
关键词
COVID-19; SARS-CoV-2; Tocilizumab; Older adult; Elderly; Mortality; Respiratory failure;
D O I
10.1016/j.ijid.2022.05.038
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: Evidence supports tocilizumab (TCZ) benefit and safety in adult patients with severe COVID19. However, its effectiveness in critically ill older adult patients remains questionable. Thus, the study aimed to evaluate the safety and effectiveness of TCZ in older critically ill patients with COVID-19.Methods: A multicenter, retrospective study for all critically ill older adults (aged >= 65 years) with confirmed COVID-19 infection and admitted to the intensive care units (ICUs). Eligible patients were categorized into two groups based on TCZ use during ICU stay (control vs TCZ). Propensity score (PS) matching was used (1:1 ratio) based on the selected criteria. The primary outcome was the in-hospital mortality.Results: A total of 368 critically ill older adult patients were included in the study. Fifty one patients (13.8%) received TCZ. The in-hospital mortality was lower in the TCZ group (HR 0.41; 95% CI 0.22-0.76, Pvalue = 0.005). Patients who received TCZ had lower odds of respiratory failure requiring mechanical ventilation (OR [95% CI]: 0.32 [0.10-0.98], P- value = 0.04). No statistically significant differences were found between the two groups for 30-days mortality, ventilator-free days, length of stay, and complications during ICU stay.Conclusion: Tocilizumab use in critically ill older adult patients with COVID-19 is associated with lower in-hospital mortality and a similar safety profile. (c) 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )
引用
收藏
页码:252 / 259
页数:8
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