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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Clin+Med 2021 ; 10 (8): ä Nephropedia Template TP
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Tocilizumab Improves the Prognosis of COVID-19 in Patients with High IL-6 #MMPMID33918563
Flisiak R; Jaroszewicz J; Rogalska M; Lapinski T; Berkan-Kawinska A; Bolewska B; Tudrujek-Zdunek M; Kozielewicz D; Rorat M; Leszczynski P; Klos K; Kowalska J; Pabjan P; Piekarska A; Mozer-Lisewska I; Tomasiewicz K; Pawlowska M; Simon K; Polanska J; Zarebska-Michaluk D
J Clin Med 2021[Apr]; 10 (8): ä PMID33918563show ga
Despite direct viral effect, the pathogenesis of coronavirus disease 2019 (COVID-19) includes an overproduction of cytokines including interleukin 6 (IL-6). Therefore, tocilizumab (TOC), a monoclonal antibody against IL-6 receptors, was considered as a possible therapeutic option. Patients were selected from the SARSTer database, containing 2332 individuals with COVID-19. Current study included 825 adult patients with moderate to severe course. Analysis was performed in 170 patients treated with TOC and 655 with an alternative medication. The end-points of treatment effectiveness were death rate, need for mechanical ventilation, and clinical improvement. Patients treated with TOC were balanced compared to non-TOC regarding gender, age, BMI, and prevalence of coexisting conditions. Significant effect of TOC on death was demonstrated in patients with baseline IL-6 > 100 pg/mL (hazard ratio [HR]: 0.21, 95% confidence interval [CI]: 0.08-0.57). The best effectiveness of TOC was achieved in patients with a combination of baseline IL-6 > 100 pg/mL and either SpO2 = 90% (HR: 0.07) or requiring oxygen supplementation (HR: 0.18). Tocilizumab administration in COVID-19 reduces mortality and speeds up clinical improvement in patients with a baseline concentration of IL-6 > 100 pg/mL, particularly if they need oxygen supplementation owing to the lower value of SpO2 = 90%.