TOCILIZUMAB for COVID-19 Patients

TOCILIZUMAB for near-death COVID-19 Patients

Prompted by a woman, who's father died of COVID-19, 2 hours after doctors administered TOCILIZUMAB.
She lost her father, and was obviously distraught.

This post is for:
Anyone who has a loved one in the hospital for covid-19,
and the doctor tells you, "His condition is worsening. Our last resort is to administer TOCILIZUMAB."

Before you start screaming
    NO! NO! NO!. That drug kills people!!!

Please read the following clinical study results and make up your mind - on the outcome of 500+ patients instead of 1.

**********†"******************"******
TOCILIZUMAB in patients with SEVERE  COVID-19:
A TESEO cohort study
& The CORIMUNO randomised clinical trial
AUGUST, 2020

--- DISCUSSION:
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.
Also, the study was to assess:
 Death in patients with severe COVID-19
       pneumonia who received "standardcare" treatment, ie, no TOCILIZUMAB.

*Results*
Those treated with TOCILIZUMAB, were already battling:
     hypertension
     Diabetes
And more had symptoms such as:
      headache and
     cough.

Of the 544 patients in this study:
- 73 patients died
           in the "standard care" group
                  (no TOCILIZUMAB)
- 13 patients died
           treated with standard care
             + TOCILIZUMAB

Patients who received TOCILIZUMAB showed a significant reduction in:
- Risk of invasive mechanical ventilation or
- risk of death
when compared with those receiving "standard care" only.

A Last Resort
The association with the use of TOCILIZUMAB was stronger when overall mortality risk was analysed alone.

Case-controlled French study
Our results are consistent with those of a smaller case-controlled French study in which death or ICU admissions were higher in patients who did not receive TOCILIZUMAB than those who did (72% vs 25%).

CORIMUNO
The CORIMUNO randomised clinical trial
also anticipates a beneficial effect of TOCILIZUMAB when compared with standard  care.

Cytokine Storm
The natural history of severe COVID-19 pneumonia is thought to be driven by a so-called Cytokine Storm.

Anakinra
TOCILIZUMAB can be considered together with anakinra as one of the immunomodulatory drugs that have been tested in clinical care for the treatment of severe COVID-19 pneumonia.

IRL
The real-life setting, including three different hospitals, accounted for the heterogenicity in clinical characteristics and disease severity across intervention groups.

... in the unadjusted analysis the magnitude of the beneficial effect associated with TOCILIZUMAB could have been underestimated.

... the benefit of TOCILIZUMAB could be greater in patients with a greater risk of death or mechanical ventilation.

Adverse Effects
A significantly higher prevalence of infection in the TOCILIZUMAB group.

A case of severe herpes simplex virus 1 hepatitis in the TOCILIZUMAB group suggests the importance of screening for herpes virus reactivation, especially if glucocorticoids are added .

In a study conducted in Wuhan, China,
84  of 201 patients developed acute respiratory distress syndrome, and
44 of them died.

European study
 In a recent large European study with 1,591 patients admitted to ICUs in Italy showed that
1,150 received mechanical ventilation,
     137 received non-invasive ventilation
      441 died

...Less Deaths, same symptoms
Treatment in the present study was for mortality.
The rates of mechanical ventilation remaind the same.

Limitations of this Study
Our study is not a randomised comparison.
The results rely on the usual assumptions about the model being correctly specified.

The participants who received standard care only were older, and therefore at higher baseline risk of invasive ventilation and death.

TOCILIZUMAB supply was intermittent over the recruitment phase because of shortages.

*********
AUGUST, 2020
TOCILIZUMAB in patients with SEVERE COVID-19:
A cohort study

FULL PAPER WITH DATA
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30173-9/fulltext

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