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Tocilizumab treatment in severe COVID-19: a multicenter retrospective study with matched controls

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dc.contributor.authorMert, Ali
dc.contributor.authorVAHABOĞLU, HALUK
dc.contributor.authorARSLAN, FERHAT
dc.contributor.authorBatirel, Ayse
dc.contributor.authorSaracoglu, Kemal Tolga
dc.contributor.authorBastug, Aliye
dc.contributor.authorCagatay, Atahan
dc.contributor.authorIRMAK, İLİM
dc.contributor.authorTELLİ DİZMAN, GÜLÇİN
dc.contributor.authorErtenli, Ihsan
dc.contributor.authorAltunal, Lutfiye Nilsun
dc.contributor.authorERTÜRK ŞENGEL, BUKET
dc.contributor.authorBayram, Mehmet
dc.contributor.authorOmma, Ahmet
dc.contributor.authorAmikishiyev, Shirkhan
dc.contributor.authorAypak, Adalet
dc.contributor.authorBes, Cemal
dc.contributor.authorBOLUKÇU, SİBEL
dc.contributor.authorIcten, Sacit
dc.contributor.authorTOPELİ İSKİT, ARZU
dc.contributor.authorBektas, Murat
dc.contributor.authorArslan, Birsen Yigit
dc.contributor.authorOzturk, Sinan
dc.contributor.authorComoglu, Senol
dc.contributor.authorAydin, Selda
dc.contributor.authorKucuksahin, Orhan
dc.contributor.authorIcacan, Ozan Cemal
dc.contributor.authorInce, Burak
dc.contributor.authorAghamuradov, Sarvan
dc.contributor.authorMutlu, Melek Yalcin
dc.contributor.authorSimsek, Funda
dc.contributor.authorEmre, Salih
dc.contributor.authorUstun, Cemal
dc.contributor.authorErgen, Pinar
dc.contributor.authorAydin, Ozlem
dc.contributor.authorMERİÇ KOÇ, MELİHA
dc.contributor.authorSevindik, Omur Gokmen
dc.contributor.authorODABAŞI, ZEKAVER
dc.contributor.authorKORTEN, VOLKAN
dc.contributor.authorBodur, Hurrem
dc.contributor.authorGuner, Rahmet
dc.contributor.authorÜNAL, SERHAT
dc.contributor.authorKocak, Mehmet
dc.contributor.authorGül, Ahmet
dc.contributor.institutionauthorBOLUKÇU, SİBEL
dc.contributor.institutionauthorMERİÇ KOÇ, MELİHA
dc.date.accessioned2021-09-21T20:59:08Z
dc.date.available2021-09-21T20:59:08Z
dc.date.issued2021-09-01T00:00:00Z
dc.description.abstractCoronavirus disease-2019 (COVID-19) associated pneumonia may progress into acute respiratory distress syndrome (ARDS). Some patients develop features of macrophage activation syndrome (MAS). Elevated levels of IL-6 were reported to be associated with severe disease, and anti-IL-6R tocilizumab has been shown to be effective in some patients. This retrospective multicenter case-control study aimed to evaluate the efficacy of tocilizumab in hospitalized COVID-19 patients, who received standard of care with or without tocilizumab. Primary outcome was the progression to intubation or death. PSMATCH (SAS) procedure was used to achieve exact propensity score (PS) matching. Data from 1289 patients were collected, and study population was reduced to 1073 based on inclusion-exclusion criteria. The composite outcome was observed more frequently in tocilizumab-users, but there was a significant imbalance between arms in all critical parameters. Primary analyses were carried out in 348 patients (174 in each arm) after exact PS matching according to gender, ferritin, and procalcitonin. Logistic regression models revealed that tocilizumab significantly reduced the intubation or death (OR 0.40, p = 0.0017). When intubation is considered alone, tocilizumab-users had > 60% reduction in odds of intubation. Multiple imputation approach, which increased the size of the matched patients up to 506, provided no significant difference between arms despite a similar trend for intubation alone group. Analysis of this retrospective cohort showed more frequent intubation or death in tocilizumab-users, but PS-matched analyses revealed significant results for supporting tocilizumab use overall in a subset of patients matched according to gender, ferritin and procalcitonin levels.
dc.identifier.doi10.1007/s00296-021-04965-6
dc.identifier.pubmed34515808
dc.identifier.scopus85114767140
dc.identifier.urihttp://hdl.handle.net/20.500.12645/29479
dc.identifier.wosWOS:000695386300001
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAcute respiratory distress syndrome
dc.subjectCOVID-19
dc.subjectCytokine storm
dc.subjectInterleukin-6 (IL-6)
dc.subjectMacrophage activation syndrome
dc.subjectPneumonia
dc.subjectTocilizumab
dc.titleTocilizumab treatment in severe COVID-19: a multicenter retrospective study with matched controls
dc.typeArticle
dspace.entity.typePublication
local.avesis.id4816699d-19e9-44b6-a10d-f391e95b87c1
local.publication.goal03 - Sağlık ve Kaliteli Yaşam
local.publication.isinternational1
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