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oai:docta.ucm.es:20.500.14352/1309292026-01-27T01:00:27Zcom_20.500.14352_14col_20.500.14352_15

Combination therapy with tocilizumab and corticosteroids for aged patients with severe COVID-19 pneumonia: A single-center retrospective study López Medrano, Francisco Pérez-Jacoiste Asín, María Asunción Fernández Ruiz, Mario Lalueza Blanco, Antonio Maestro De La Calle, Guillermo Origüen Sabater, Julia Martínez López, Joaquín San Juan Garrido, Rafael Bueno Zamora, Héctor José Paz Artal, Estela Natividad Lumbreras Bermejo, Carlos Juan Pablos Álvarez, José Luis Aguado García, José María 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. 2026-01-26T08:36:34Z 2026-01-26T08:36:34Z 2021-04-01 journal article 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. 1878-3511 10.1016/j.ijid.2021.02.099 https://hdl.handle.net/20.500.14352/130929 https://doi.org/10.1016/J.IJID.2021.02.099 https://www.ijidonline.com/article/S1201-9712(21)00185-5/fulltext eng open access Elsevier