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2022-03-28

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cc-by (c) Camon, Ana Maria et al., 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/198567

C-reactive protein cut-off for early tocilizumab and dexamethasone prescription in hospitalized patients with COVID-19

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Recurs relacionat

https://doi.org/10.1038/s41598-022-08882-x

Resum

Dexamethasone and tocilizumab have been associated with reduction in mortality, however, the beneficial effect is not for all patients and the impact on viral replication is not well defined. We hypostatized that C-reactive protein (CRP) could help in the identification of patients requiring anti-inflammatory therapy. Patients admitted for > 48 h in our hospital for a confirmed or suspected infection by SARS-CoV-2 from February 2020 to February 2021 were retrospectively evaluated. The primary outcome was mortality at 30 days. Demographics and the most relevant variables related with the outcome were included. CRP was stratified by percentiles. Univariate and multivariate analysis were performed. A total of 3218 patients were included with a median (IQR) age of 66 (74-78) years and 58.9% were males. The rate of intensive care unit admission was 24.4% and the 30-day mortality rate was 11.8%. Within the first 5 days from admission, 1018 (31.7%) patients received dexamethasone and 549 tocilizumab (17.1%). The crude analysis showed a mortality reduction in patients receiving dexamethasone when CRP was > 13.75 mg/dL and > 3.5 mg/dL for those receiving tocilizumab. Multivariate analysis identified the interaction of CRP > 13.75 mg/dL with dexamethasone (OR 0.57; CI 95% 0.37-0.89, P = 0014) and CRP > 3.5 mg/dL with tocilizumab (0.65; CI95%:0.44-0.95, P = 0.029) as independent predictors of mortality. Our results suggest that dexamethasone and tocilizumab are associated with a reduction in mortality when prescribed to patients with a certain inflammatory activity assessed by C-reactive protein.

Matèries

Proteïnes de la sang, Administració de medicaments, Agents antiinflamatoris, Malalts hospitalitzats, COVID-19, SARS-CoV-2

Matèries (anglès)

Blood proteins, Administration of drugs, Antiinflammatory agents, Hospital patients, COVID-19, SARS-CoV-2

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Articles publicats en revistes (Fonaments Clínics)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (ISGlobal)

Citació

CAMON, Ana maria, ALONSO MORALEJO, Rodrigo, MUÑOZ BELLIDO, F. j., CARDOZO ESPINOLA, Celia, BERNAL-MAURANDI, Javier, ALBIACH, Laia, AGÜERO, Daiana, MARCOS, Ma. angeles, AMBROSIONI, Juan, BODRO, Marta, CHUMBITA, Mariana, DE LA MORA, Lorena, GARCÍA POUTON, Nicole, DUEÑAS, Gerard, HERNÁNDEZ-MENESES, Marta, INCIARTE PORTILLO, Alexy, CUESTA CHASCO, Genoveva, MEIRA, Fernanda, MORATA, Laura, PUERTA-ALCALDE, Pedro, RICO, Verónica, HERRERA, Sabina, TUSET, Montse, CASTRO, Pedro, PRIETO GONZÁLEZ, Sergio, ALMUEDO RIERA, Alex, MUÑOZ, José, MENSA PUEYO, Josep, SANJUAN, Gemma, NICOLÁS ARFELIS, Josep maria, DEL RIO, Ana, VILA ESTAPÉ, Jordi, GARCÍA, Felipe, MARTÍNEZ, José antonio, GARCIA VIDAL, Carolina, SORIANO VILADOMIU, Alex, Hospital Clinic of Barcelona COVID-19 Research Group, MIRÓ MEDA, José m. (josé maría), LÓPEZ-SOTO, Alfonso. C-reactive protein cut-off for early tocilizumab and dexamethasone prescription in hospitalized patients with COVID-19. _Scientific Reports_. 2022. Vol. 12, núm. 1, pàgs. 5250. [consulta: 28 de gener de 2026]. ISSN: 2045-2322. [Disponible a: https://hdl.handle.net/2445/198567]

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