RT Journal Article
T1 Combination therapy with tocilizumab and corticosteroids for aged patients with severe COVID-19 pneumonia: A single-center retrospective study
A1 López Medrano, Francisco
A1 Pérez-Jacoiste Asín, María Asunción
A1 Fernández Ruiz, Mario
A1 Lalueza Blanco, Antonio
A1 Maestro De La Calle, Guillermo
A1 Origüen Sabater, Julia
A1 Martínez López, Joaquín
A1 San Juan Garrido, Rafael
A1 Bueno Zamora, Héctor José
A1 Paz Artal, Estela Natividad
A1 Lumbreras Bermejo, Carlos Juan
A1 Pablos Álvarez, José Luis
A1 Aguado García, José María
AB Background: The role of combination immunomodulatory therapy with systemic corticosteroids and tocilizumab (TCZ) for aged patients with COVID-19-associated cytokine release syndrome remains unclear.Methods: A retrospective single-center study was conducted on consecutive patients aged ≥65 years who developed severe COVID-19 between 03 March and 01 May 2020 and were treated with corticosteroids at various doses (methylprednisolone 0.5mg/kg/12h to 250mg/24h), either alone (CS group) or associated with intravenous tocilizumab (400-600mg, one to three doses) (CS-TCZ group). The primary outcome was all-cause mortality by day +14, whereas secondary outcomes included mortality by day +28 and clinical improvement (discharge and/or a ≥2 point decrease on a 6-point ordinal scale) by day +14. Propensity score (PS)-based adjustment and inverse probability of treatment weights (IPTW) were applied.Results: Totals of 181 and 80 patients were included in the CS and CS-TCZ groups, respectively. All-cause 14-day mortality was lower in the CS-TCZ group, both in the PS-adjusted (hazard ratio [HR]: 0.34; 95% confidence interval [CI]: 0.17-0.68; P=0.002) and IPTW-weighted models (odds ratio [OR]: 0.38; 95% CI: 0.21-0.68; P=0.001). This protective effect was also observed for 28-day mortality (PS-adjusted HR: 0.38; 95% CI: 0.21-0.72; P=0.003). Clinical improvement by day +14 was higher in the CS-TCZ group with IPTW analysis only (OR: 2.26; 95% CI: 1.49-3.41; P<0.001). The occurrence of secondary infection was similar between both groups.Conclusions: The combination of corticosteroids and TCZ was associated with better outcomes among patients aged ≥65 years with severe COVID-19.
PB Elsevier
SN 1878-3511
YR 2021
FD 2021-04-01
LK https://hdl.handle.net/20.500.14352/130929
UL https://hdl.handle.net/20.500.14352/130929
LA eng
NO López-Medrano F, Pérez-Jacoiste Asín MA, Fernández-Ruiz M, Carretero O, Lalueza A, Maestro de la Calle G, et al. Combination therapy with tocilizumab and corticosteroids for aged patients with severe COVID-19 pneumonia: a single-center retrospective study. Int J Infect Dis. 2021;105:487–494. doi:10.1016/j.ijid.2021.02.099.
DS Docta Complutense
RD 18 mar 2026