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616-036.21:578.834-036-07-085 (1) |
Patologie. Medicină clinică (6996) |
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SM ISO690:2012 BERSAN, Sebastian, COJOCARU, Stela, RUSSU, Irina. Efficacy of tocilizumab treatment in patients with severe forms of COVID-19. In: Revista de Ştiinţe ale Sănătăţii din Moldova, 2022, nr. 3 An.1(29), p. 120. ISSN 2345-1467. |
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Revista de Ştiinţe ale Sănătăţii din Moldova | ||||||
Numărul 3 An.1(29) / 2022 / ISSN 2345-1467 | ||||||
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CZU: 616-036.21:578.834-036-07-085 | ||||||
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Background. Cytokines may have a negative impact, increasing the risk of mortality, in patients with COVID-19 and exaggerated systemic inflammatory response. The effect and role of tocilizumab (TCZ) in COVID-19 is still under discussion, given the divergent results of current clinical trials. Objective of the study. To evaluate the efficacy of tocilizumab on the outcome of severe COVID-19 in patients who did not require non-invasive/invasive ventilation at the time of TCZ treatment. Materials and methods. The study was conducted on a sample of 66 patients with severe forms of COVID-19, admitted to CHID T. Ciorba, between 12.2020 and 07.2021, who underwent treatment with TCZ 200/400 mg single administration. The diagnosis of COVID-19 was confirmed by detection of RNA-SARS CoV-2 by PCR tests. Patients did not receive antivirals for SARS CoV-2. Results. TCZ was administered during the cytokine storm (11.34 ± 0.31 days of illness), with manifestations: fever > 38ºC, asthenia, dyspnea, SpO2 ≤ 94%, bilateral lung involvement with negative radiological evolution, need for O2 supplementation 10 L/min. Comorbidities: hypertension and chronic cardiovascular disease 33 (50%) patients, diabetes mellitus 21 (31.8%), obesity 20 (30.3%), chronic renal diseases 10 (15%), COPD 4 (6%). Post-TCZ fever subsided in 1.72 ± 0.15 days, SpO2 increased in 4.52 ± 0.33 days, O2-therapy lasted 9.37 ± 0.64 days, and dyspnea subsided in 13.9 ± 0.7 days. In the ICU for non-invasive/invasive ventilation were transferred 18 (27.3%) patients. Conclusion. Tocilizumab was effective, stopping the progression of cytokine storm in 72.7% patients with severe forms of COVID-19. TCZ in doses of 200/400mg can be used in the treatment of COVID-19 when an exaggerated systemic inflammatory response is suspected. |
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Cuvinte-cheie COVID-19, treatment, Tocilizumab, TCZ, COVID-19, Tratament, tocilizumab, TCZ |
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