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10.1016/j.jaut.2020.102512

http://scihub22266oqcxt.onion/10.1016/j.jaut.2020.102512
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C7332925!7332925!32646770
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suck abstract from ncbi


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pmid32646770      J+Autoimmun 2020 ; 114 (ä): 102512
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  • Clinical characteristics and predictors of survival in adults with coronavirus disease 2019 receiving tocilizumab #MMPMID32646770
  • Morrison AR; Johnson JM; Griebe KM; Jones MC; Stine JJ; Hencken LN; To L; Bianchini ML; Vahia AT; Swiderek J; Ramesh MS; Peters MA; Smith ZR
  • J Autoimmun 2020[Nov]; 114 (ä): 102512 PMID32646770show ga
  • Coronavirus disease 2019 (COVID-19) can progress to cytokine storm that is associated with organ dysfunction and death. The purpose of the present study is to determine clinical characteristics associated with 28 day in-hospital survival in patients with coronavirus disease 2019 (COVID-19) that received tocilizumab. This was a retrospective observational cohort study conducted at a five hospital health system in Michigan, United States. Adult patients with confirmed COVID-19 that were admitted to the hospital and received tocilizumab for cytokine storm from March 1, 2020 through April 3, 2020 were included. Patients were grouped into survivors and non-survivors based on 28 day in-hospital mortality. Study day 0 was defined as the day tocilizumab was administered. Factors independently associated with in-hospital survival at 28 days after tocilizumab administration were assessed. Epidemiologic, demographic, laboratory, prognostic scores, treatment, and outcome data were collected and analyzed. Clinical response was collected and defined as a decline of two levels on a six-point ordinal scale of clinical status or discharged alive from the hospital. Of the 81 patients included, the median age was 64 (58?71) years and 56 (69.1%) were male. The 28 day in-hospital mortality was 43.2%. There were 46 (56.8%) patients in the survivors and 35 (43.2%) in the non-survivors group. On study day 0 no differences were noted in demographics, clinical characteristics, severity of illness scores, or treatments received between survivors and non-survivors. C-reactive protein was significantly higher in the non-survivors compared to survivors. Compared to non-survivors, recipients of tocilizumab within 12 days of symptom onset was independently associated with survival (adjusted OR: 0.296, 95% CI: 0.098?0.889). SOFA score ?8 on day 0 was independently associated with mortality (adjusted OR: 2.842, 95% CI: 1.042?7.753). Clinical response occurred more commonly in survivors than non-survivors (80.4% vs. 5.7%; p < 0.001). Improvements in the six-point ordinal scale and SOFA score were observed in survivors after tocilizumab. Early receipt of tocilizumab in patients with severe COVID-19 was an independent predictor for in-hospital survival at 28 days.
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