Changes in Inflammatory Markers after Administration of Tocilizumab in COVID-19: A Single-Center Retrospective Study
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Features | All | Survived | Died | p-Value |
---|---|---|---|---|
n = 29 (100.0%) | n = 18 (62.1%) | n = 11 (37.9%) | ||
Males (n) | 20 (69.0%) | 13 (72.2%) | 7 (63.6%) | 0.63 |
Age (years) | 58.0 (53.0–69.0) | 55.0 (51.5–62.0) | 65.0 (58.0–73.5) | 0.13 |
No comorbidities (n) | 2 (6.9%) | 1 (5.6%) | 1 (9.1%) | 0.72 |
Charlson Comorbidity Index (n) | 2.0 (1.0–4.0) | 2.0 (1.0–3.0) | 4.0 (2.0–4.0) | 0.1 |
Arterial hypertension (n) | 14 (44.8%) | 10 (55.6%) | 4 (36.4%) | 0.32 |
Diabetes (n) | 7 (24.1%) | 3 (16.7%) | 4 (36.4%) | 0.23 |
Obesity (n) | 11 (37.9%) | 4 (22.2%) | 7 (63.6%) | 0.026 |
Chronic kidney disease (n) | 4 (13.8%) | 2 (11.1%) | 2 (18.2%) | 0.59 |
Hypothyroidism (n) | 2 (6.9%) | 2 (11.1%) | 0 (0.0%) | 0.25 |
Heart failure (n) | 1 (3.4%) | 0 (0.0%) | 1 (9.1%) | 0.19 |
Ischemic heart disease (n) | 2 (6.9%) | 2 (11.1%) | 0 (0.0%) | 0.25 |
Atrial fibrillation (n) | 1 (3.4%) | 0 (0.0%) | 1 (9.1%) | 0.19 |
Asthma/COPD (n) | 3 (10.3%) | 1 (5.6%) | 2 (18.2%) | 0.28 |
Depression (n) | 1 (3.4%) | 0 (0.0%) | 1 (9.1%) | 0.19 |
Sclerosis multiplex (n) | 1 (3.4%) | 0 (0.0%) | 1 (9.1%) | 0.19 |
Rheumatoid arthritis (n) | 1 (3.4%) | 0 (0.0%) | 1 (9.1%) | 0.19 |
Glucocorticoids (n) | 8 (27.6%) | 5 (27.8%) | 5 (45.5%) | 0.33 |
Fever (n) | 25 (86.2%) | 17 (94.4%) | 8 (72.7%) | 0.1 |
Cough (n) | 24 (82.8%) | 18 (100.0%) | 6 (54.5%) | 0.02 |
Dyspnea (n) | 26 (89.7%) | 16 (88.9%) | 10 (90.9%) | 0.86 |
Chloroquine (n) | 18 (62.1%) | 14 (77.8%) | 4 (36.4%) | 0.026 |
Lopinavir-ritonavir (n) | 12 (41.4%) | 8 (44.4%) | 4 (36.4%) | 0.67 |
Remdesivir (n) | 2 (6.9%) | 1 (5.6%) | 1 (9.1%) | 0.72 |
Plasma of convalescents (n) | 2 (6.9%) | 1 (5.6%) | 1 (9.1%) | 0.72 |
Stay in ICU (n) | 14 (48.3%) | 3 (16.7%) | 11 (100.0%) | <0.001 |
Intubation (n) | 12 (41.4%) | 1 (5.6%) | 11 (100.0%) | <0.001 |
Length of stay in hospital (n) | 18.0 (15.0–25.0) | 23.0 (18.0–28.2) | 15.0 (12.0–17.0) | 0.008 |
Laboratory findings at admission | ||||
WBC (G/L) | 6.0 (4.4–8.3) | 5.8 (4.1–8.0) | 7.3 (4.8–9.6) | 0.29 |
LYMPH (G/L) | 0.8 (0.7–1.2) | 1.0 (0.7–1.2) | 0.8 (0.7–0.8) | 0.74 |
PLT (G/L) | 206.0 (172.0–244.0) | 204.0 (162.5–234.0) | 206.0 (191.0–269.5) | 0.44 |
CRP (mg/L) | 104.7 (70.7–182.4) | 84.5 (59.5–206.0) | 121.4 (87.9–162.9) | 0.71 |
IL-6 (pg/mL) | 64.1 (39.8–101.2) | 56.9 (40.3–69.7) | 82.5 (31.0–322.4) | 0.32 |
Time from admission to tocilizumab administration (days) | 4.0 (3.0–7.0) | 4.0 (3.2–6.8) | 5.0 (2.5–6.0) | 0.77 |
Number of days of treatment by tocilizumab (days) | 2.0 (2.0–2.0) | 2.0 (2.0–2.0) | 2.0 (1.0–2.0) | 0.042 |
Number of tocilizumab treatment (n) | 2.0 (2.0–2.0) | 2.0 (2.0–2.0) | 2.0 (1.0–2.0) | 0.035 |
No of Patient | Sex | Age (Years) | Comorbidities | Results of the First Blood Culture | Results of the Control Blood Culture | Cause of Death |
---|---|---|---|---|---|---|
1. | Female | 73 | None | Staphylococcus epidermidis MSSE | Acinetobacter baumannii resistant to carbapenems | Multiorgan failure |
2. | Female | 83 | Depression | Staphylococcus epidermidis MSSE | Acinetobacter baumannii resistant to carbapenems | Multiorgan failure |
3. | Female | 88 | Atherosclerosis, cerebral aneurysm, osteoporosis, Sclerosis multiplex | Negative | Negative | Respiratory failure |
4. | Male | 58 | Obesity, Chronic Pulmonary Obstructive Disease, Heart Failure | Staphylococcus epidermidis MRSE | Negative | Multiorgan failure |
5. | Female | 70 | Asthma, Atrial Fibrillation, Type 2 Diabetes, Rheumatoid Arthritis, Arterial Hypertension, Obesity | Methicillin-resistant coagulase-negative Staphylococcus MRCoNS | Not performed | Multiorgan failure |
6. | Male | 59 | Obesity, type 2 diabetes, chronic kidney disease | Staphylococcus epidermidis MRSE | Not performed | Multiorgan failure |
7. | Male | 43 | Obesity, arterial hypertension | Negative | Negative | Multiorgan failure |
8. | Male | 74 | Obesity, type 2 diabetes, arterial hypertension | Methicillin-sensitive coagulase-negative Staphylococcus MSCoNS | Negative | Multiorgan failure |
9. | Male | 65 | None | Negative | Negative | Respiratory failure |
10. | Male | 45 | Asthma, obesity | Negative | Negative | Sudden cardiac death |
11. | Male | 58 | Type 2 diabetes, Arterial hypertension, hypercholesterolaemia | Methicillin-sensitive coagulase-negative Staphylococcus MSCONS | Acinetobacter baumannii resistant to carbapenems | Multiorgan failure |
Seven Days Before Tocilizumab | Seven Days After Tocilizumab | Fourteen Days After Tocilizumab | |
---|---|---|---|
White Blood Count (G/L) | Cut-off: ≥9.92 AUROC: 0.55 (95% CI: 0.32–0.79) Sensitivity: 22.2% Specificity: 94.1% | Cut-off: ≥8.40 AUROC: 0.85 (95% CI: 0.70–1.00) Sensitivity: 72.7% Specificity: 88.9% | Cut-off: ≥11.01 AUROC: 0.89 (95% CI: 0.76–1.00) Sensitivity: 90.1% Specificity: 88.9% |
Lactate dehydrogenase (U/L) | Cut-off: ≥748 AUROC: 0.63 (95% CI: 0.39–0.87) Sensitivity: 33.3% Specificity: 100.0% | Cut-off: ≥466 AUROC: 0.78 (95% CI: 0.59–0.96) Sensitivity: 90.9% Specificity: 72.2% | Cut-off: ≥493 AUROC: 0.82 (95% CI: 0.65–0.99) Sensitivity: 90.9% Specificity: 83.3% |
C-reactive protein (mg/L) | Cut-off: ≥278 AUROC: 0.40 (95% CI: 0.17–0.63) Sensitivity: 11.1% Specificity: 94.1% | Cut-off: ≥167 AUROC: 0.37 (95% CI: 0.17–0.58) Sensitivity: 18.2% Specificity: 94.4% | Cut-off: ≥218 AUROC: 0.44 (95% CI: 0.22–0.66) Sensitivity: 9.1% Specificity: 100.0% |
Interleukin-6 (pg/mL) | Cut-off: ≥651 AUROC: 0.59 (95% CI: 0.34–0.83) Sensitivity: 33.3% Specificity: 100.0% | Cut-off: ≥417 AUROC: 0.81 (95% CI: 0.63–0.98) Sensitivity: 81.8% Specificity: 83.3% | Cut-off: ≥425 AUROC: 0.88 (95% CI: 0.74–1.00) Sensitivity: 81.8% Specificity: 83.3% |
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Olewicz-Gawlik, A.; Ginter-Matuszewska, B.; Kamiński, M.; Adamek, A.; Bura, M.; Mozer-Lisewska, I.; Kowala-Piaskowska, A. Changes in Inflammatory Markers after Administration of Tocilizumab in COVID-19: A Single-Center Retrospective Study. J. Clin. Med. 2022, 11, 107. https://doi.org/10.3390/jcm11010107
Olewicz-Gawlik A, Ginter-Matuszewska B, Kamiński M, Adamek A, Bura M, Mozer-Lisewska I, Kowala-Piaskowska A. Changes in Inflammatory Markers after Administration of Tocilizumab in COVID-19: A Single-Center Retrospective Study. Journal of Clinical Medicine. 2022; 11(1):107. https://doi.org/10.3390/jcm11010107
Chicago/Turabian StyleOlewicz-Gawlik, Anna, Barbara Ginter-Matuszewska, Mikołaj Kamiński, Agnieszka Adamek, Maciej Bura, Iwona Mozer-Lisewska, and Arleta Kowala-Piaskowska. 2022. "Changes in Inflammatory Markers after Administration of Tocilizumab in COVID-19: A Single-Center Retrospective Study" Journal of Clinical Medicine 11, no. 1: 107. https://doi.org/10.3390/jcm11010107
APA StyleOlewicz-Gawlik, A., Ginter-Matuszewska, B., Kamiński, M., Adamek, A., Bura, M., Mozer-Lisewska, I., & Kowala-Piaskowska, A. (2022). Changes in Inflammatory Markers after Administration of Tocilizumab in COVID-19: A Single-Center Retrospective Study. Journal of Clinical Medicine, 11(1), 107. https://doi.org/10.3390/jcm11010107