OBJECTIVES: No agent has yet been proven to be effective for the treatment of patients with severe COVID-19. METHODS: We conducted a pilot prospective open, single-arm multicentre study on off-label use of tocilizumab (TCZ) involving 63 hospitalised adult patients (56 males, age 62.6±12.5) with severe COVID-19. Clinical and laboratory parameters were prospectively collected at baseline, day 1, 2, 7 and 14. No moderate-to-severe adverse events attributable to TCZ were recorded. RESULTS: We observed a significant improvement in the levels of ferritin, C-reactive protein, D-dimer. The ratio of the partial pressure of oxygen (Pa02) to the fraction of inspired oxygen (Fi02) improved (mean±SD Pa02/Fi02 at admission: 152±53; at day 7: 283.73±115.9, at day 14: 302.2±126, p<0.05). The overall mortality was 11%; D-dimer level at baseline, but not IL-6 levels were predictors of mortality. TCZ administration within 6 days from admission in the hospital was associated with an increased likelihood of survival (HR 2.2 95%CI 1.3-6.7, p<0.05). CONCLUSIONS: In hospitalised adult patients with severe COVID-19, TCZ could be a safe option. An improvement in respiratory and laboratory parameters was observed. Future controlled trials in patients with severe illness are urgently needed to confirm the definite benefit with IL-6 target therapy.
OBJECTIVES: No agent has yet been proven to be effective for the treatment of patients with severe COVID-19. METHODS: We conducted a pilot prospective open, single-arm multicentre study on off-label use of tocilizumab (TCZ) involving 63 hospitalised adult patients (56 males, age 62.6±12.5) with severe COVID-19. Clinical and laboratory parameters were prospectively collected at baseline, day 1, 2, 7 and 14. No moderate-to-severe adverse events attributable to TCZ were recorded. RESULTS: We observed a significant improvement in the levels of ferritin, C-reactive protein, D-dimer. The ratio of the partial pressure of oxygen (Pa02) to the fraction of inspired oxygen (Fi02) improved (mean±SD Pa02/Fi02 at admission: 152±53; at day 7: 283.73±115.9, at day 14: 302.2±126, p<0.05). The overall mortality was 11%; D-dimer level at baseline, but not IL-6 levels were predictors of mortality. TCZ administration within 6 days from admission in the hospital was associated with an increased likelihood of survival (HR 2.2 95%CI 1.3-6.7, p<0.05). CONCLUSIONS: In hospitalised adult patients with severe COVID-19, TCZ could be a safe option. An improvement in respiratory and laboratory parameters was observed. Future controlled trials in patients with severe illness are urgently needed to confirm the definite benefit with IL-6 target therapy.
Authors: Shiv Lal Soni; Kamal Kajal; L N Yaddanapudi; Pankaj Malhotra; Goverdhan Dutt Puri; Ashish Bhalla; Mini P Singh; Inderpaul Singh Sehgal; Vipin Koushal; Neelam Varma; Manisha Biswal; P V M Lakshmi; Sadhna Sharma; Vikas Suri; Z Deepy; Sant Ram; Jaivinder Yadav; Navin Pandey; Prashant Sharma; Nabhajit Malik; Kapil Goyal; Aseem Mehra; Swapnajeet Sahoo; Ritin Mohindra; Jijo Francis; Mudit Bhargava; Karan Singla; Preena Babu; Amiy Verma; Niranjan Shiwaji Khaire; R R Guru Journal: Indian J Med Res Date: 2021 Jan & Feb Impact factor: 2.375
Authors: Kanokwan Bunsawat; Stephen M Ratchford; Jeremy K Alpenglow; Soung Hun Park; Catherine L Jarrett; Josef Stehlik; Adam S Smith; Russell S Richardson; D Walter Wray Journal: J Appl Physiol (1985) Date: 2020-11-19
Authors: Shruti Gupta; Wei Wang; Salim S Hayek; Lili Chan; Kusum S Mathews; Michal L Melamed; Samantha K Brenner; Amanda Leonberg-Yoo; Edward J Schenck; Jared Radbel; Jochen Reiser; Anip Bansal; Anand Srivastava; Yan Zhou; Diana Finkel; Adam Green; Mary Mallappallil; Anthony J Faugno; Jingjing Zhang; Juan Carlos Q Velez; Shahzad Shaefi; Chirag R Parikh; David M Charytan; Ambarish M Athavale; Allon N Friedman; Roberta E Redfern; Samuel A P Short; Simon Correa; Kapil K Pokharel; Andrew J Admon; John P Donnelly; Hayley B Gershengorn; David J Douin; Matthew W Semler; Miguel A Hernán; David E Leaf Journal: JAMA Intern Med Date: 2021-01-01 Impact factor: 21.873
Authors: Narasimha M Beeraka; SubbaRao V Tulimilli; Medha Karnik; Surya P Sadhu; Rajeswara Rao Pragada; Gjumrakch Aliev; SubbaRao V Madhunapantula Journal: Biomed Res Int Date: 2021-06-01 Impact factor: 3.411