Liu Hongli, Niu Chengu, Elkhapery Ahmed, Zhu Kaiwen, Nair Lakshmi G, Anjum Zauraiz, Iyer Charoo, Faisal Hafsa, Chow Ming
Internal Medicine, Rochester General Hospital, USA.
Pulmonary and Critical Care, Rochester General Hospital, USA.
J Community Hosp Intern Med Perspect. 2023 Jan 10;13(1):11-19. doi: 10.55729/2000-9666.1141. eCollection 2023.
Controversies remain regarding the safety of tocilizumab in the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this study, we seek to describe the infectious complications after tocilizumab in COVID patients and determine the related risk factors.
A single-center retrospective observational study was conducted among adult patients with SARS-CoV-2 infection admitted between 06/01/2020 and 12/31/2021 who received tocilizumab at our institution. Baseline demographics and laboratory values are obtained through reviewing electronic medical records. Risk factors of infectious complications after tocilizumab are identified through regression analysis. Statistics are performed using SPSS. P-value <0.05 is considered statistically significant.
Out of the 52 patients identified, infectious complications after tocilizumab were documented in 30 patients (57.7%). The most common infections include pneumonia, urinary tract infections, and bacteremia of unknown sources. Overall mortality was 42.3%. Through multivariate regression analysis, age more than 65, hyperglycemia on admission, and tocilizumab administration more than 2 days after hospital admission are independent risk factors associated with developing infections.
In real-world experience, infectious complications are not uncommon in COVID patients who receive tocilizumab. Early use of tocilizumab may be of benefit. More rigorous patient selection and monitoring should be explored in future studies.
关于托珠单抗治疗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的安全性仍存在争议。在本研究中，我们试图描述COVID患者使用托珠单抗后的感染并发症，并确定相关危险因素。
对2020年6月1日至2021年12月31日在我院接受托珠单抗治疗的成年SARS-CoV-2感染患者进行单中心回顾性观察研究。通过查阅电子病历获取基线人口统计学和实验室值。通过回归分析确定托珠单抗治疗后感染并发症的危险因素。使用SPSS进行统计分析。P值<0.05被认为具有统计学意义。
在确定的52例患者中，30例（57.7%）记录了使用托珠单抗后的感染并发症。最常见的感染包括肺炎、尿路感染和不明来源的菌血症。总体死亡率为42.3%。通过多因素回归分析，年龄超过65岁、入院时血糖高以及入院后2天以上使用托珠单抗是与感染发生相关的独立危险因素。
在实际临床经验中，接受托珠单抗治疗的COVID患者出现感染并发症并不罕见。早期使用托珠单抗可能有益。未来研究应探索更严格的患者选择和监测方法。
