Effectiveness and safety of intravenous tocilizumab to treat COVID-19-associated hyperinflammatory syndrome: Covizumab-6 observational cohort.

Although the starting event in COVID-19 is a viral infection some patients present with an over-exuberant inflammatory response, leading to acute lung injury (ALI) and adult respiratory distress syndrome (ARDS). Since IL-6 plays a critical role in the inflammatory response, we assessed the efficacy and safety of tocilizumab (TCZ) in this single-centre, observational study in all Covid-19 in-patient with a proven SARS-CoV-2 rapidly progressing infection to prevent ALI and ARDS. 104 patients with COVID-19 treated with TCZ had a lower mortality rate (5·8%) compared with the regional mortality rate (11%), hospitalized patient's mortality (10%), and slightly lower than hospitalized patients treated with our standard of care alone (6%). We found that TCZ rapidly decreased acute phase reactants, ferritin and liver release of proteins. D-Dimer decreased slowly. We did not observe specific safety concerns. Early administration of IL6-R antagonists in COVID-19 patients with impending hyperinflammatory response, may be safe and effective treatment to prevent, ICU admission and further complications.

Characterization of the population with severe iron deficiency anemia at risk of requiring intravenous iron supplementation.

Iron deficiency anemia is the most frequent cause of anemia world-wide and is a very common disorder in daily medical practice. Heavy menstrual bleeding (menorrhagia) and pregnancy and delivery can cause significant iron loss leading to severe anemia The aim of the present study was to characterize the population requiring intravenous iron and identify whether gynecological and obstetric iron loss are frequent indications for treatment. MATERIAL AND METHODS: Restrospective, single center study performed in a tertiary level university hospital from January 2014 to December 2016. RESULTS: During the 3-year study period, there were 4529 treatments with intravenous iron (45.98% in men vs. 54.02% in women). The population group from 10 to 54 years of age made up 19.33% of the total treatments, with 35.93% in men and 64.01% in women (Fisher exact test, p<0.001). Intravenous iron administration for gynecological and obstetric reasons was required in 20.54% and 24.82% of the total population, respectively, representing >45% of the indications for treatment in this population. CONCLUSIONS: The need for intravenous iron is related to anemia refractory to oral treatment or the need for rapid iron recovery. Our results show that women of fertile age are a population at risk of requiring intravenous iron as compared to a male population of the same age. It is mainly due to blood los related to pregnancy, delivery and puerperium as well as heavy menstrual bleeding.