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10.1093/cid/ciaa954 http://scihub22266oqcxt.onion/10.1093/cid/ciaa954 32651997!7454462!32651997     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Clin+Infect+Dis 2021 ; 73 (2): e445-e454 Nephropedia Template TP {{tp|p=32651997|t=2021. Tocilizumab for Treatment of Mechanically Ventilated Patients With COVID-19 |pdf=|usr=}}{{32651997}} gab.com Text Tocilizumab for Treatment of Mechanically Ventilated Patients With COVID-19 JO: Clin Infect Dis http://www.kidney.de/pget.php?&tw=1&pmid=32651997 #FOAvip BACKGROUND: Severe coronavirus disease 2019 (COVID-19) can manifest in rapid decompensation and respiratory failure with elevated inflammatory markers, consistent with cytokine release syndrome for which IL-6 blockade is an approved treatment. METHODS: We assessed effectiveness and safety of IL-6 blockade with tocilizumab in a single-center cohort of patients with COVID-19 requiring mechanical ventilation. The primary endpoint was survival probability postintubation; secondary analyses included an ordinal illness severity scale integrating superinfections. Outcomes in patients who received tocilizumab compared with tocilizumab-untreated controls were evaluated using multivariable Cox regression with propensity score inverse probability of treatment weighting (IPTW). RESULTS: 154 patients were included, of whom 78 received tocilizumab and 76 did not. Median follow-up was 47 days (range, 28-67). Baseline characteristics were similar between groups, although tocilizumab-treated patients were younger (mean: 55 vs 60 years), less likely to have chronic pulmonary disease (10% vs 28%), and had lower D-dimer values at time of intubation (median: 2.4 vs 6.5 mg/dL). In IPTW-adjusted models, tocilizumab was associated with a 45% reduction in hazard of death (HR, .55; 95% CI, .33-.90) and improved status on the ordinal outcome scale [OR per 1-level increase, .58; .36-.94). Although tocilizumab was associated with an increased proportion of patients with superinfections (54% vs 26%; P < .001), there was no difference in 28-day case fatality rate among tocilizumab-treated patients with versus without superinfection (22% vs 15%; P = .42). Staphylococcus aureus accounted for ~50% of bacterial pneumonia. CONCLUSIONS: In this cohort of mechanically ventilated COVID-19 patients, tocilizumab was associated with lower mortality despite higher superinfection occurrence. Twit Text FOAVip Tocilizumab for Treatment of Mechanically Ventilated Patients With COVID-19 ????Clin Infect Dis http://www.kidney.de/pget.php?&tw=1&pmid=32651997 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32651997 #FOAvip English Wikipedia <ref>{{Cite pmid|32651997}}</ref> Tocilizumab for Treatment of Mechanically Ventilated Patients With COVID-19 #MMPMID32651997 Somers EC; Eschenauer GA; Troost JP; Golob JL; Gandhi TN; Wang L; Zhou N; Petty LA; Baang JH; Dillman NO; Frame D; Gregg KS; Kaul DR; Nagel J; Patel TS; Zhou S; Lauring AS; Hanauer DA; Martin E; Sharma P; Fung CM; Pogue JM Clin Infect Dis 2021[Jul]; 73 (2): e445-e454 PMID32651997show ga BACKGROUND: Severe coronavirus disease 2019 (COVID-19) can manifest in rapid decompensation and respiratory failure with elevated inflammatory markers, consistent with cytokine release syndrome for which IL-6 blockade is an approved treatment. METHODS: We assessed effectiveness and safety of IL-6 blockade with tocilizumab in a single-center cohort of patients with COVID-19 requiring mechanical ventilation. The primary endpoint was survival probability postintubation; secondary analyses included an ordinal illness severity scale integrating superinfections. Outcomes in patients who received tocilizumab compared with tocilizumab-untreated controls were evaluated using multivariable Cox regression with propensity score inverse probability of treatment weighting (IPTW). RESULTS: 154 patients were included, of whom 78 received tocilizumab and 76 did not. Median follow-up was 47 days (range, 28-67). Baseline characteristics were similar between groups, although tocilizumab-treated patients were younger (mean: 55 vs 60 years), less likely to have chronic pulmonary disease (10% vs 28%), and had lower D-dimer values at time of intubation (median: 2.4 vs 6.5 mg/dL). In IPTW-adjusted models, tocilizumab was associated with a 45% reduction in hazard of death (HR, .55; 95% CI, .33-.90) and improved status on the ordinal outcome scale [OR per 1-level increase, .58; .36-.94). Although tocilizumab was associated with an increased proportion of patients with superinfections (54% vs 26%; P < .001), there was no difference in 28-day case fatality rate among tocilizumab-treated patients with versus without superinfection (22% vs 15%; P = .42). Staphylococcus aureus accounted for ~50% of bacterial pneumonia. CONCLUSIONS: In this cohort of mechanically ventilated COVID-19 patients, tocilizumab was associated with lower mortality despite higher superinfection occurrence. |*COVID-19 Drug Treatment[MESH] |*Respiration, Artificial[MESH] |Antibodies, Monoclonal, Humanized[MESH] |Humans[MESH] |SARS-CoV-2[MESH]Tocilizumab for Treatment of Mechanically Ventilated Patients With COV(epmc).pdf DeepDyve Pubget Overpricing