<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>SARS-CoV-2 infection demonstrates a wide range of severity. More severe cases demonstrate a cytokine storm with elevated serum interleukin-6, hence IL-6 receptor antibody tocilizumab was tried for the management of severe cases.</p>
</sec>
<sec><h3>Aims</h3>
<p>Effect of tocilizumab on ventilator-free days among critically ill SARS-CoV-2 patients.</p>
</sec>
<sec><h3>Method</h3>
<p>Retrospective propensity score matching study, comparing mechanically ventilated patients who received tocilizumab to a control group.</p>
</sec>
<sec><h3>Results</h3>
<p>29 patients in the intervention group were compared to 29 controls. Matched groups were similar. Ventilator-free days were more numerous in the intervention group (SHR 2.7, 95% CI: 1.2 – 6.3; p = 0.02), ICU mortality rate was not different (37.9% versus 62%, p = 0.1), actual ventilator-free periods were significantly longer in tocilizumab group (mean difference 4.7 days; p = 0.02). Sensitivity analysis showed a significantly lower hazard ratio of death in tocilizumab group (HR 0.49, 95% CI: 0.25 – 0.97; p = 0.04). There was no difference in positive cultures among groups (55.2% in tocilizumab group versus 34.5% in the control; p = 0.1).</p>
</sec>
<sec><h3>Conclusion</h3>
<p>Tocilizumab may improve the composite outcome of ventilator-free days at day 28 among mechanically ventilated SARS-CoV-2 patients; it is associated with significantly longer actual ventilator-free periods, and insignificantly lower mortality and higher superinfection.</p>
</sec>
</abstract>

Background
SARS-CoV-2 infection demonstrates a wide range of severity. More severe cases demonstrate a cytokine storm with elevated serum interleukin-6, hence IL-6 receptor antibody tocilizumab was tried for the management of severe cases.

Aims
Effect of tocilizumab on ventilator-free days among critically ill SARS-CoV-2 patients.

Method
Retrospective propensity score matching study, comparing mechanically ventilated patients who received tocilizumab to a control group.

Results
29 patients in the intervention group were compared to 29 controls. Matched groups were similar. Ventilator-free days were more numerous in the intervention group (SHR 2.7, 95% CI: 1.2 – 6.3; p = 0.02), ICU mortality rate was not different (37.9% versus 62%, p = 0.1), actual ventilator-free periods were significantly longer in tocilizumab group (mean difference 4.7 days; p = 0.02). Sensitivity analysis showed a significantly lower hazard ratio of death in tocilizumab group (HR 0.49, 95% CI: 0.25 – 0.97; p = 0.04). There was no difference in positive cultures among groups (55.2% in tocilizumab group versus 34.5% in the control; p = 0.1).

Conclusion
Tocilizumab may improve the composite outcome of ventilator-free days at day 28 among mechanically ventilated SARS-CoV-2 patients; it is associated with significantly longer actual ventilator-free periods, and insignificantly lower mortality and higher superinfection.

Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis

Anaesthesia Department, Faculty of Medicine

South Carolina University School of Medicine

Critical Care Department, Keck School of Medicine

Romanian Journal of Anaesthesia and Intensive Care

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background
SARS-CoV-2 infection demonstrates a wide range of severity. More severe cases demonstrate a cytokine storm with elevated serum interleukin-6, hence...

Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis

Article Category: Original paper

Publié en ligne: 14 janv. 2023

Pages: 1 - 7

DOI: https://doi.org/10.2478/rjaic-2022-0001

Mots clés
SARS-CoV-2, tocilizumab, ventilator-free days

© 2022 Ahmed F. Mady et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Effect of Tocilizumab on “Ventilator Free Days” Composite Outcome in SARS-CoV-2 Patients: A Retrospective Competing Risk Analysis

Article Category: Original paper

Publié en ligne: 14 janv. 2023

Pages: 1 - 7

DOI: https://doi.org/10.2478/rjaic-2022-0001

Mots clésSARS-CoV-2, tocilizumab, ventilator-free days

© 2022 Ahmed F. Mady et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
SARS-CoV-2, tocilizumab, ventilator-free days