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Purpose: Real-world experience with tocilizumab in combination with dexamethasone in patients with severe coronavirus disease (COVID-19) needs to be investigated.

Materials and Methods: A retrospective cohort study was conducted to evaluate the effect of severity-adjusted dosing of dexamethasone in combination with tocilizumab for severe COVID-19 from August 2020 to August 2021. The primary endpoint was 30-day clinical recovery, which was defined as no oxygen requirement or referral after recovery.

Results: A total of 66 patients were evaluated, including 33 patients in the dexamethasone (Dexa) group and 33 patients in the dexamethasone plus tocilizumab (DexaToci) group. The DexaToci group showed a statistically significant benefit in 30-day clinical recovery, compared to the Dexa group (p=0.024). In multivariable analyses, peak FiO2 within 3 days and tocilizumab combination were consistently significant for 30-day recovery (all p<0.05). The DexaToci group showed a significantly steeper decrease in FiO2 (-4.2±2.6) than the Dexa group (−2.7±2.6; p=0.021) by hospital day 15. The duration of oxygen requirement was significantly shorter in the DexaToci group than the Dexa group (median, 10.0 days vs. 17.0 days; p=0.006). Infectious complications and cellular and humoral immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the convalescence stage were not different between the two groups.

Conclusion: A combination of severity-adjusted dexamethasone and tocilizumab for the treatment of severe COVID-19 improved clinical recovery without increasing infectious complications or hindering the immune response against SARS-CoV-2.

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기사명 저자명 페이지 원문 목차
Intraoperative radiotherapy for resectable pancreatic cancer using a low-energy X-ray source : postoperative complications and early outcomes Yeona Cho, Jun Won Kim, Hyung Sun Kim, Joon Seong Park, Ik Jae Lee p. 405-412, [1-3]

Platelet function and genotype after DES implantation in East Asian patients : rationale and characteristics of the PTRG-DES consortium Ae-Young Her, Young-Hoon Jeong, Byeong-Keuk Kim, Hyung Joon Joo, Kiyuk Chang, Yongwhi Park, Young Bin Song, Sung Gyun Ahn, Jung-Won Suh, Sang Yeup Lee, Jung Rae Cho, Hyo-Soo Kim, Moo Hyun Kim, Do-Sun Lim, Eun-Seok Shin p. 413-421, [1-3]

Validation of machine learning models to predict adverse outcomes in patients with COVID-19 : a prospective pilot study Hyung-Jun Kim, JoonNyung Heo, Deokjae Han, Hong Sang Oh p. 422-429, [1-5]

Severity-adjusted dexamethasone dosing and tocilizumab combination for severe COVID-19 Jin Yeong Hong, Jae-Hoon Ko, Jinyoung Yang, Soyoung Ha, Eliel Nham, Kyungmin Huh, Sun Young Cho, Cheol-In Kang, Doo Ryeon Chung, Jin Yang Baek ... [et al.] p. 430-439

(The) first 100 cases of endoscopic combined intrarenal surgery in Korea : matched cohort analyses versus shock-wave lithotripsy Hae Do Jung, Young Joon Moon, Ahmad J. Almujalhem, Ali Abdullah Alqahtani, Mohammed Ali Alkhureeb, Joo Yong Lee p. 440-445

Cumulative recurrence rate and risk factors for recurrent abdominal wall endometriosis after surgical treatment in a single institution Su Jin Kim, Su Hyeon Choi, Seyeon Won, Sohyun Shim, Nara Lee, Miseon Kim, Mi Kyoung Kim, Seok Ju Seong, Mi-La Kim p. 446-451

Trends in mortality, treatment, and costs of management of acute respiratory distress syndrome in South Korea : analysis of data between 2010 and 2019 Tak Kyu Oh, In-Ae Song p. 452-460, [1-4]

Thrombotic microangiopathy score as a new predictor of neurologic outcomes in patients after out-of-hospital cardiac arrest Je Sung You, Hye Sun Lee, Soyoung Jeon, Jong Wook Lee, Hyun Soo Chung, Sung Phil Chung, Taeyoung Kong p. 461-469, [1-3]

Effect of a boarding restriction protocol on emergency department crowding Ji Hwan Lee, Ji Hoon Kim, Incheol Park, Hyun Sim Lee, Joon Min Park, Sung Phil Chung, Hyeon Chang Kim, Won Jeong Son, Yun Ho Roh, Min Joung Kim p. 470-479, [1-4]

Evaluation of CRISPR-based assays for rapid detection of SARS-CoV-2 : a systematic review and meta-analysis Pei-Ying Huang, Xin Yin, Yue-Ting Huang, Qi-Qing Ye, Si-Qing Chen, Xun-Jie Cao, Tian-Ao Xie, Xu-Guang Guo p. 480-489

Exposure of the middle rectal artery and lateral ligament of the rectum following the gate approach during total mesorectal excision Cristopher Varela, Manar Nassr, Nam Kyu Kim p. 490-492

(The) time for digital health is almost here : 12th Korea Healthcare Congress 2021 : 김치국부터 마시지 말라 Harlan M. Krumholz p. 493-498

참고문헌 (27건) : 자료제공( 네이버학술정보 )

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번호 참고문헌 국회도서관 소장유무
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15 WHO Working Group on the Clinical Characterisation and Management of COVID-19 Infection. A minimal common outcome measure set for COVID-19 clinical research. Lancet Infect Dis 2020;20:e192-7. 미소장
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24 National Institutes of Health. Therapeutic management of hospitalized adults with COVID-19 [Internet] [accessed on 2021 September 23]. Available at: https://www.covid19treatmentguidelines.nih.gov/management/clinical-management/hospitalized-adults--therapeutic-management. 미소장
25 Cogliati Dezza F, Oliva A, Cancelli F, Savelloni G, Valeri S, Mauro V, et al. Determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection. Diagn Microbiol Infect Dis 2021;100:115347. 미소장
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