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Volume 12
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Article

Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France

by
Paul Laffont-Lozes
1,2,
Didier Laureillard
2,
Paul Loubet
2,
Robin Stephan
3,
Myriam Chiaruzzi
2,
Edouard Clemmer
2,
Aurelie Martin
2,
Claire Roger
4,
Laurent Muller
4,
Pierre-Géraud Claret
5,
Radjiv Goulabchand
6,
Clarisse Roux
1,
Jean-Philippe Lavigne
3,7,
Albert Sotto
2,7 and
Romaric Larcher
2,8,*
1
Department of Pharmacy, Nimes University Hospital, Place du Professeur Robert Debre, 30000 Nimes, France
2
Infectious and Tropical Diseases Department, Nimes University Hospital, Place du Professeur Robert Debre, 30000 Nimes, France
3
Department of Microbiology and Hospital Hygiene, Nimes University Hospital, Place du Professeur Robert Debre, 30000 Nimes, France
4
Anesthesiology and Critical Care Medicine Department, Nimes University Hospital, Place du Professeur Robert Debre, 30000 Nimes, France
5
Emergency Medicine Department, Nimes University Hospital, Place du Professeur Robert Debre, 30000 Nimes, France
6
Department of Internal Medicine, Nimes University Hospital, Place du Professeur Robert Debre, 30000 Nimes, France
7
VBIC (Bacterial Virulence and Chronic Infection), INSERM (French Institute of Health and Medical Research), Montpellier University, 34090 Montpellier, France
8
PhyMedExp (Physiology and Experimental Medicine), INSERM (French Institute of Health and Medical Research), CNRS (French National Centre for Scientific Research), University of Montpellier, 34090 Montpellier, France
*
Author to whom correspondence should be addressed.
Antibiotics 2023, 12(1), 88; https://doi.org/10.3390/antibiotics12010088
Submission received: 23 November 2022 / Revised: 25 December 2022 / Accepted: 30 December 2022 / Published: 4 January 2023
(This article belongs to the Special Issue Antibacterial Therapy in Adults with COVID-19)
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Abstract

We aimed to assess the factors associated with mortality in patients treated with tocilizumab for a SARS-CoV-2 pneumonia due to the delta or omicron variants of concern (VOC) and detect an effect of tocilizumab on mortality. We conducted a prospective cohort study in a tertiary hospital from 1 August 2021 to 31 March 2022 including patients with severe COVID-19, treated with tocilizumab. Factors associated with mortality were assessed in a Cox model; then, the 60-day mortality rates of COVID-19 patients treated with standard of care (SoC) +/− tocilizumab were compared after 1:1 propensity score matching. The mortality rate was 22% (N = 26/118) and was similar between delta and omicron cases (p = 0.6). The factors independently associated with mortality were age (HR 1.06; 95% CI (1.02–1.11), p = 0.002), Charlson index (HR 1.33; 95% CI (1.11–1.6), p = 0.002), WHO-CPS (HR 2.56; 95% CI (1.07–6.22) p = 0.03), and tocilizumab infusion within the first 48 h following hospital admission (HR 0.37, 95% CI (0.14–0.97), p = 0.04). No significant differences in mortality between the tocilizumab plus SoC and SoC alone groups (p = 0.5) were highlighted. However, the patients treated with tocilizumab within the 48 h following hospital admission had better survival (p = 0.04). In conclusion, our results suggested a protective effect on mortality of the early administration of tocilizumab in patients with severe COVID-19 regardless of the VOC involved.
Keywords: COVID-19; variant of concern; interleukin-6 receptor antagonist; early administration; mortality rates COVID-19; variant of concern; interleukin-6 receptor antagonist; early administration; mortality rates

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MDPI and ACS Style

Laffont-Lozes, P.; Laureillard, D.; Loubet, P.; Stephan, R.; Chiaruzzi, M.; Clemmer, E.; Martin, A.; Roger, C.; Muller, L.; Claret, P.-G.; et al. Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France. Antibiotics 2023, 12, 88. https://doi.org/10.3390/antibiotics12010088

AMA Style

Laffont-Lozes P, Laureillard D, Loubet P, Stephan R, Chiaruzzi M, Clemmer E, Martin A, Roger C, Muller L, Claret P-G, et al. Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France. Antibiotics. 2023; 12(1):88. https://doi.org/10.3390/antibiotics12010088

Chicago/Turabian Style

Laffont-Lozes, Paul, Didier Laureillard, Paul Loubet, Robin Stephan, Myriam Chiaruzzi, Edouard Clemmer, Aurelie Martin, Claire Roger, Laurent Muller, Pierre-Géraud Claret, and et al. 2023. "Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France" Antibiotics 12, no. 1: 88. https://doi.org/10.3390/antibiotics12010088

APA Style

Laffont-Lozes, P., Laureillard, D., Loubet, P., Stephan, R., Chiaruzzi, M., Clemmer, E., Martin, A., Roger, C., Muller, L., Claret, P.-G., Goulabchand, R., Roux, C., Lavigne, J.-P., Sotto, A., & Larcher, R. (2023). Effect of Tocilizumab on Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta or Omicron Variants: A Propensity-Matched Analysis in Nimes University Hospital, France. Antibiotics, 12(1), 88. https://doi.org/10.3390/antibiotics12010088

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