ir73lpi8

Property	Value
?:abstract	Effective treatments for the critically ill patient with novel coronavirus disease 2019 are desperately needed. Given the role of cytokine release syndrome in the pathogenesis of coronavirus disease 2019-associated respiratory distress, therapies aimed at mitigating cytokine release, such as the interleukin-6 receptor-inhibiting monoclonal antibody tocilizumab, represent potential treatment strategies. Therefore, we examined the outcomes of critically ill coronavirus disease 2019 patients treated with tocilizumab and factors associated with clinical improvement. DESIGN: A retrospective cohort analysis of 21-day outcomes for consecutive mechanically ventilated patients treated with tocilizumab from March 24, 2020, to May 4, 2020. SETTING: Nine ICUs at six hospitals within a hospital system in Houston, Texas, United States. PATIENTS: The first 62 coronavirus disease 2019 patients on invasive mechanical ventilation who were treated with tocilizumab, which was considered for all patients with severe disease. INTERVENTIONS: Tocilizumab was administered either at a weight-based dose of 4–8 mg/kg or at a flat dose of 400 mg, with repeat administration in some patients at the physician’s discretion. MEASUREMENTS AND MAIN RESULTS: The primary outcomes were mortality and clinical improvement, defined as extubation. By day 21 post-tocilizumab, clinical improvement occurred in 36 patients (58%) and 13 patients (21%) died. In both univariable and multivariable analyses, age less than 60 years was associated with clinical improvement. Transient transaminitis was the most common adverse reaction, occurring in 25 patients (40%). CONCLUSIONS: Based on clinical outcomes and mortality rates seen in previous reports of mechanically ventilated patients, tocilizumab, as part of the management strategy for severe coronavirus disease 2019, represents a promising option. These findings support the need for evaluation of tocilizumab in a randomized controlled trial.
is ?:annotates of	<https://research.tib.eu/covid-19/entity/ir73lpi8_hasAnnotation_C0476273> <https://research.tib.eu/covid-19/entity/ir73lpi8_hasAnnotation_C0559546>
?:creator	<https://research.tib.eu/covid-19/entity/Sirimaturos%2C_Michael%3B_Gotur%2C_Deepa_B.%3B_Patel%2C_Samir_J.%3B_Dreucean%2C_Diane%3B_Jakowenko%2C_Nicholas%3B_Cooper%2C_Megan_H.%3B_Brahmbhatt%2C_Nishal%3B_Graviss%2C_Edward_A.%3B_Nguyen%2C_Duc_T.%3B_Pingali%2C_Sai_Ravi%3B_Lin%2C_Jiejian%3B_Musick%2C_William_L.>
?:doi	<https://research.tib.eu/covid-19/entity/10.1097/cce.0000000000000232>
?:doi	10.1097/cce.0000000000000232
?:journal	Crit_Care_Explor
?:license	cc-by-nc-nd
?:pdf_json_files	document_parses/pdf_json/a3b694e775db92fff29b84d23069304152253110.json
?:pmc_json_files	document_parses/pmc_json/PMC7531754.xml.json
?:pmcid	<https://research.tib.eu/covid-19/entity/PMC7531754>
?:pmid	<https://research.tib.eu/covid-19/entity/33063035.0>
?:pmid	33063035.0
?:publication_isRelatedTo_Disease	<https://research.tib.eu/covid-19/entity/COVID-19>
is ?:relation_isRelatedTo_publication of	<https://research.tib.eu/covid-19/entity/ir73lpi8_HAS_C0063717_INHIBITS_C1609165> <https://research.tib.eu/covid-19/entity/ir73lpi8_HAS_C0948245_CAUSES_C0476273>
?:sha_id	<https://research.tib.eu/covid-19/entity/a3b694e775db92fff29b84d23069304152253110>
?:source	Medline; PMC
?:title	Clinical Outcomes Following Tocilizumab Administration in Mechanically Ventilated Coronavirus Disease 2019 Patients
?:type	<https://research.tib.eu/covid-19/vocab/Publication>
?:year	2020-10-01

Property

Value

?:abstract

Effective treatments for the critically ill patient with novel coronavirus disease 2019 are desperately needed. Given the role of cytokine release syndrome in the pathogenesis of coronavirus disease 2019-associated respiratory distress, therapies aimed at mitigating cytokine release, such as the interleukin-6 receptor-inhibiting monoclonal antibody tocilizumab, represent potential treatment strategies. Therefore, we examined the outcomes of critically ill coronavirus disease 2019 patients treated with tocilizumab and factors associated with clinical improvement. DESIGN: A retrospective cohort analysis of 21-day outcomes for consecutive mechanically ventilated patients treated with tocilizumab from March 24, 2020, to May 4, 2020. SETTING: Nine ICUs at six hospitals within a hospital system in Houston, Texas, United States. PATIENTS: The first 62 coronavirus disease 2019 patients on invasive mechanical ventilation who were treated with tocilizumab, which was considered for all patients with severe disease. INTERVENTIONS: Tocilizumab was administered either at a weight-based dose of 4–8 mg/kg or at a flat dose of 400 mg, with repeat administration in some patients at the physician’s discretion. MEASUREMENTS AND MAIN RESULTS: The primary outcomes were mortality and clinical improvement, defined as extubation. By day 21 post-tocilizumab, clinical improvement occurred in 36 patients (58%) and 13 patients (21%) died. In both univariable and multivariable analyses, age less than 60 years was associated with clinical improvement. Transient transaminitis was the most common adverse reaction, occurring in 25 patients (40%). CONCLUSIONS: Based on clinical outcomes and mortality rates seen in previous reports of mechanically ventilated patients, tocilizumab, as part of the management strategy for severe coronavirus disease 2019, represents a promising option. These findings support the need for evaluation of tocilizumab in a randomized controlled trial.

is ?:annotates of