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《MedRxiv，5月25日，Hydroxychloroquine and Tocilizumab Therapy in COVID-19 Patients - An Observational Study》

  • 来源专题：COVID-19科研动态监测
  • 编译者： zhangmin
  • 发布时间：2020-05-26

  • Hydroxychloroquine and Tocilizumab Therapy in COVID-19 Patients - An Observational Study

    View ORCID ProfileAndrew Ip, View ORCID ProfileDonald A Berry, Eric Hansen, View ORCID ProfileAndre H Goy, Andrew L Pecora, Brittany A Sinclaire, Urszula Bednarz, Michael Marafelias, Scott M Berry, Nicholas S Berry, Shivam Mathura, Ihor S Sawczuk, Noa Biran, View ORCID ProfileRonaldo C Go, Steven Sperber, Julia A Piwoz, Bindu Balani, Cristina Cicogna, Rani Sebti, Jason Zuckerman, Keith M Rose, Lisa Tank, Laurie Jacobs, Jason Korcak, Sarah L Timmapuri, Joseph P Underwood III, Gregory Sugalski, Carol Barsky, Daniel W Varga, Arif Asif, Joseph C Landolfi, View ORCID ProfileStuart L Goldberg

    doi: https://doi.org/10.1101/2020.05.21.20109207

    Abstract

    Background: Hydroxychloroquine has been touted as a COVID-19 treatment. Tocilizumab, an inhibitor of IL-6, has been proposed as a treatment of critically ill patients. Objective: To describe the association between mortality and hydroxychloroquine or tocilizumab therapy among hospitalized COVID-19 patients. Design: Retrospective observational cohort study of electronic health records Setting: 13-hospital network spanning the state of New Jersey. Participants: Patients hospitalized between March 1, 2020 and April 22, 2020 with positive polymerase chain reaction results for SARS-CoV-2. Follow up was through May 5, 2020. Main Outcomes: The primary outcome was death. Results: Among 2512 hospitalized patients with COVID-19 there have been 547 deaths (22%), 1539 (61%) discharges and 426 (17%) remain hospitalized. 1914 (76%) received at least one dose of hydroxychloroquine and 1473 (59%) received hydroxychloroquine with azithromycin. After adjusting for imbalances via propensity modeling, compared to receiving neither drug, there were no significant differences in associated mortality for patients receiving any hydroxychloroquine during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]), hydroxychloroquine alone (HR, 1.02 [95% CI, 0.83-1.27]), or hydroxychloroquine with azithromycin (HR, 0.98 [95% CI, 0.75-1.28]).

    *注，本文为预印本论文手稿，是未经同行评审的初步报告，其观点仅供科研同行交流，并不是结论性内容，请使用者谨慎使用.

  • 原文来源：https://www.medrxiv.org/content/10.1101/2020.05.21.20109207v1
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  • 《NEJM，5月7日，Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19》
    • 来源专题：COVID-19科研动态监测
    • 编译者：xuwenwhlib
    • 发布时间：2020-05-08
    • Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19 List of authors. Joshua Geleris, M.D., Yifei Sun, Ph.D., Jonathan Platt, Ph.D., Jason Zucker, M.D., Matthew Baldwin, M.D., George Hripcsak, M.D., Angelena Labella, M.D., Daniel Manson, M.D., Christine Kubin, Pharm.D., R. Graham Barr, M.D., Dr.P.H., Magdalena E. Sobieszczyk, M.D., M.P.H., and Neil W. Schluger, M.D. May 7, 2020 DOI: 10.1056/NEJMoa2012410 Abstract BACKGROUND Hydroxychloroquine has been widely administered to patients with Covid-19 without robust evidence supporting its use. METHODS We examined the association between hydroxychloroquine use and intubation or death at a large medical center in New York City. Data were obtained regarding consecutive patients hospitalized with Covid-19, excluding those who were intubated, died, or discharged within 24 hours after presentation to the emergency department (study baseline). The primary end point was a composite of intubation or death in a time-to-event analysis. We compared outcomes in patients who received hydroxychloroquine with those in patients who did not, using a multivariable Cox model with inverse probability weighting according to the propensity score.
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  • 《Lancet，6月24日，Tocilizumab in patients with severe COVID-19: a retrospective cohort study》
    • 来源专题：COVID-19科研动态监测
    • 编译者：zhangmin
    • 发布时间：2020-06-26
    • Tocilizumab in patients with severe COVID-19: a retrospective cohort study Prof Giovanni Guaraldi, MD † Marianna Meschiari, MD † Prof Alessandro Cozzi-Lepri, PhD Jovana Milic, MD Roberto Tonelli, MD Marianna Menozzi, MD Published:June 24, 2020DOI:https://doi.org/10.1016/S2665-9913(20)30173-9 Summary Background No therapy is approved for COVID-19 pneumonia. The aim of this study was to assess the role of tocilizumab in reducing the risk of invasive mechanical ventilation and death in patients with severe COVID-19 pneumonia who received standard of care treatment. Methods This retrospective, observational cohort study included adults (≥18 years) with severe COVID-19 pneumonia who were admitted to tertiary care centres in Bologna and Reggio Emilia, Italy, between Feb 21 and March 24, 2020, and a tertiary care centre in Modena, Italy, between Feb 21 and April 30, 2020. All patients were treated with the standard of care (ie, supplemental oxygen, hydroxychloroquine, azithromycin, antiretrovirals, and low molecular weight heparin), and a non-randomly selected subset of patients also received tocilizumab. Tocilizumab was given either intravenously at 8 mg/kg bodyweight (up to a maximum of 800 mg) in two infusions, 12 h apart, or subcutaneously at 162 mg administered in two simultaneous doses, one in each thigh (ie, 324 mg in total), when the intravenous formulation was unavailable.
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