Adre Lorenzo Abednego B, Catangui Josefino S, Bondoc Marvin Keith V, Abdurahman Kenerham M
Department of Medicine, Manila Doctors Hospital, Manila, PHL.
Section of Cardiology, Department of Medicine, Manila Doctors Hospital, Manila, PHL.
Cureus. 2023 May 28;15(5):e39604. doi: 10.7759/cureus.39604. eCollection 2023 May.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has challenged healthcare systems worldwide since late 2019. The interleukin-6 inhibitor tocilizumab is one of the most studied agents with a proven benefit for patients with severe and critical coronavirus disease 2019 (COVID-19) pneumonia. Known adverse effects of this agent include upper respiratory tract infections, headache, hypertension, and transaminitis. The risk of secondary bacterial complications among patients who were given tocilizumab remains unclear. A descriptive study was done that included all laboratory-confirmed COVID-19 patients with a severe or critical severity for the year 2021 who received at least one dose of tocilizumab. Of the 1220 laboratory-confirmed COVID-19 patients admitted to Manila Doctors Hospital in the year 2021, a total of 139 patients fulfilled the inclusion criteria and were included in the study. Twenty-one patients, or 15% of the study population, were diagnosed with hospital-acquired pneumonia. This value was similar to previous studies showing the prevalence of secondary bacterial infections among patients who were given tocilizumab. These values could potentially aid clinicians when deciding whether or not to give one or two doses of tocilizumab to patients with severe or critical COVID-19 pneumonia. Given that many patients who are admitted with severe or critical COVID-19 pneumonia often have multiple decompensated comorbidities, the decision to give tocilizumab to manage severe COVID-19 should be weighed against the risk of hospital-acquired pneumonia.
自2019年末以来，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行给全球医疗系统带来了挑战。白细胞介素-6抑制剂托珠单抗是研究最多的药物之一，已证实对重症和危重症2019冠状病毒病（COVID-19）肺炎患者有益。该药物已知的不良反应包括上呼吸道感染、头痛、高血压和转氨酶升高。接受托珠单抗治疗的患者发生继发性细菌并发症的风险尚不清楚。进行了一项描述性研究，纳入了2021年所有实验室确诊的重症或危重症COVID-19患者，这些患者至少接受了一剂托珠单抗。在2021年入住马尼拉医生医院的1220例实验室确诊的COVID-19患者中，共有139例符合纳入标准并被纳入研究。21例患者（占研究人群的15%）被诊断为医院获得性肺炎。这一数值与之前关于接受托珠单抗治疗患者继发性细菌感染患病率的研究结果相似。这些数值可能有助于临床医生决定是否对重症或危重症COVID-19肺炎患者给予一剂或两剂托珠单抗。鉴于许多因重症或危重症COVID-19肺炎入院的患者往往有多种失代偿性合并症，在决定给予托珠单抗治疗重症COVID-19时，应权衡医院获得性肺炎的风险。
