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Clin Immunol ; 223: 108631, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33189888

RESUMEN

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.


Asunto(s)
Lesión Pulmonar Aguda/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Tratamiento Farmacológico de COVID-19 , Síndrome de Liberación de Citoquinas/tratamiento farmacológico , Inflamación/tratamiento farmacológico , Síndrome de Dificultad Respiratoria/tratamiento farmacológico , SARS-CoV-2/fisiología , Lesión Pulmonar Aguda/mortalidad , Anciano , COVID-19/mortalidad , Estudios de Cohortes , Síndrome de Liberación de Citoquinas/mortalidad , Femenino , Ferritinas/metabolismo , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Humanos , Inflamación/mortalidad , Masculino , Persona de Mediana Edad , Receptores de Interleucina-6/inmunología , Síndrome de Dificultad Respiratoria/mortalidad , Análisis de Supervivencia
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