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Long-term effect of tocilizumab on mortality, readmissions, persistent symptoms and lung function in SARS-CoV-2 patients 1 year after hospital discharge: A matched cohort study - 29/11/23

Doi : 10.1016/j.resmer.2023.101064 
Ignacio Cardona-Pascual, PharmD a, Mercedes Pallero, MD, PhD b, c, David Berlana, PharmD, PhD a, , Ana Villar, MD, PhD b, Jose Bruno Montoro-Ronsano, PharmD, PhD a, Cristina Berastegui, MD, PhD b
a Pharmacy Department, Vall Hebron Barcelona Campus Hospital, Barcelona, Spain 
b Respiratory Department, Vall Hebron Barcelona Campus Hospital, Pg Vall Hebron 119, Barcelona, Spain 
c CIBER de Enfermedades Respiratorias (CIBERES), Av Monforte Lemos 3-5, Madrid, Spain 

Corresponding author at: Pharmacy Department, Vall Hebron Barcelona Campus Hospital, Pg. Vall Hebron 119, 08035 Barcelona, Spain.Pharmacy DepartmentVall Hebron Barcelona Campus HospitalPg. Vall Hebron 119Barcelona08035Spain

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Abstract

Background

Tocilizumab is presumed to be an effective and safe treatment for severe SARS-Cov-2, but its usefulness has not been investigated yet for long-term outcomes. This study aimed to evaluate the influence of tocilizumab on mortality in patients with SARS-CoV-2 throughout the year following discharge.

Methods

A retrospective observational analysis was performed on electronic medical records of patients with SARS-CoV2 who were discharged from our hospital after surviving the first wave in March-April 2020. Logistic regression was used to analyse the effect of tocilizumab on mortality, as the main outcome, and propensity-score analysis to further validate their effect. Secondary outcomes were readmissions, persistent symptoms and lung function evolution. Patients were selected by matching their individual propensity for receiving therapy with tocilizumab, conditional on their demographic and clinical variables.

Results

A total of 405 patients were included in the mortality study (33.6 % were treated with tocilizumab) and 390 were included in the assessment of persistent symptoms. After propensity-score analysis, no association between tocilizumab use and 1-year overall mortality was found (HR= 2.05, 95 % CI: 0.21–19.98). No differences regarding persistent symptoms (OR= 1.01 95 %CI 0.57–1.79), nor lung function parameters (forced vital capacity: coefficient -0.16 95 %CI -0.45 to 0.14) were found throughout the year follow-up between control and tocilizumab group.

Conclusions

The administration of tocilizumab in patients with SARS-CoV-2 did not show any effect on long-term mortality. Identically, no association were found regarding readmissions, persistent symptoms or lung function evolution and tocilizumab administration in our cohort of patients after 1 year follow-up.

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Keywords : COVID-19, Tocilizumab, Mortality, Post-COVID-19, Respiratory symptoms

Abbreviations : . PFT, PS, PSM, HR, OR, CI


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Vol 84

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