Tocilizumab treatment of COVID-19: relevance of delay in therapy initiation in middle-income countries
Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, low- and middle- income countries had less access to monoclonal antibodies, such as tocilizumab (TCZ), compared to high-income countries. This retrospective cohort study aimed at evaluating the impact of a delayed TCZ administra...
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| Language: | English |
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The Journal of Infection in Developing Countries
2025-02-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/19914 |
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| author | Branko Beronja Olja Stevanović Nataša Nikolić Nikola Mitrović Tatjana Gazibara Nevena Todorović Ana Filipović Jelena Dotlic Mihailo Stjepanović Jelena Simić Ivana Milosevic |
| author_facet | Branko Beronja Olja Stevanović Nataša Nikolić Nikola Mitrović Tatjana Gazibara Nevena Todorović Ana Filipović Jelena Dotlic Mihailo Stjepanović Jelena Simić Ivana Milosevic |
| author_sort | Branko Beronja |
| collection | DOAJ |
| description |
Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, low- and middle- income countries had less access to monoclonal antibodies, such as tocilizumab (TCZ), compared to high-income countries. This retrospective cohort study aimed at evaluating the impact of a delayed TCZ administration on patient outcomes, and at determining the optimum timing of TCZ initiation for COVID-19 pneumonia in Serbia.
Methodology: The study included 150 patients who received TCZ at a tertiary referral center. The outcomes analyzed in this study were the need for an intensive care unit (ICU) treatment and mortality.
Results: The multiple Cox proportional hazard model suggested that the delay in TCZ administration was an independent predictor of needing ICU treatment and mortality. The receiver operating characteristic (ROC) curve showed that patients who received TCZ after 7.5 days since the onset of symptoms had 74.4% higher chances of needing ICU treatment. Receiving TCZ after 9.5 days since the onset of symptoms, increased the chances of mortality by 78.9%. The multiple Cox proportional hazard model suggested that TCZ administration after 7.5 days since the onset of symptoms increased the hazard for ICU admission by 24.5%; and the hazard of mortality increased by 46.1% after 9.5 days since the onset of symptoms.
Conclusions: This study emphasizes the importance of timely administration of TCZ in COVID-19 pneumonia. Better outcomes were observed when TCZ was administered up to 7.5 days since the onset of symptoms.
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| format | Article |
| id | doaj-art-ad8bdb9c853e41f8a6ca5873c63ac4cd |
| institution | Kabale University |
| issn | 1972-2680 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-ad8bdb9c853e41f8a6ca5873c63ac4cd2025-08-20T03:52:43ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802025-02-01190210.3855/jidc.19914Tocilizumab treatment of COVID-19: relevance of delay in therapy initiation in middle-income countriesBranko Beronja0Olja Stevanović1Nataša Nikolić2Nikola Mitrović3Tatjana Gazibara4Nevena Todorović5Ana Filipović6Jelena Dotlic7Mihailo Stjepanović8Jelena Simić9Ivana Milosevic10Faculty of Medicine, University of Belgrade, Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Belgrade, SerbiaClinic of Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, SerbiaClinic of Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Belgrade, SerbiaClinic for Lung Diseases, Clinical Center of Serbia, Belgrade, SerbiaClinic of Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Belgrade, Serbia Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, low- and middle- income countries had less access to monoclonal antibodies, such as tocilizumab (TCZ), compared to high-income countries. This retrospective cohort study aimed at evaluating the impact of a delayed TCZ administration on patient outcomes, and at determining the optimum timing of TCZ initiation for COVID-19 pneumonia in Serbia. Methodology: The study included 150 patients who received TCZ at a tertiary referral center. The outcomes analyzed in this study were the need for an intensive care unit (ICU) treatment and mortality. Results: The multiple Cox proportional hazard model suggested that the delay in TCZ administration was an independent predictor of needing ICU treatment and mortality. The receiver operating characteristic (ROC) curve showed that patients who received TCZ after 7.5 days since the onset of symptoms had 74.4% higher chances of needing ICU treatment. Receiving TCZ after 9.5 days since the onset of symptoms, increased the chances of mortality by 78.9%. The multiple Cox proportional hazard model suggested that TCZ administration after 7.5 days since the onset of symptoms increased the hazard for ICU admission by 24.5%; and the hazard of mortality increased by 46.1% after 9.5 days since the onset of symptoms. Conclusions: This study emphasizes the importance of timely administration of TCZ in COVID-19 pneumonia. Better outcomes were observed when TCZ was administered up to 7.5 days since the onset of symptoms. https://jidc.org/index.php/journal/article/view/19914COVID-19tocilizumabdelaymortalityintensive care unit |
| spellingShingle | Branko Beronja Olja Stevanović Nataša Nikolić Nikola Mitrović Tatjana Gazibara Nevena Todorović Ana Filipović Jelena Dotlic Mihailo Stjepanović Jelena Simić Ivana Milosevic Tocilizumab treatment of COVID-19: relevance of delay in therapy initiation in middle-income countries Journal of Infection in Developing Countries COVID-19 tocilizumab delay mortality intensive care unit |
| title | Tocilizumab treatment of COVID-19: relevance of delay in therapy initiation in middle-income countries |
| title_full | Tocilizumab treatment of COVID-19: relevance of delay in therapy initiation in middle-income countries |
| title_fullStr | Tocilizumab treatment of COVID-19: relevance of delay in therapy initiation in middle-income countries |
| title_full_unstemmed | Tocilizumab treatment of COVID-19: relevance of delay in therapy initiation in middle-income countries |
| title_short | Tocilizumab treatment of COVID-19: relevance of delay in therapy initiation in middle-income countries |
| title_sort | tocilizumab treatment of covid 19 relevance of delay in therapy initiation in middle income countries |
| topic | COVID-19 tocilizumab delay mortality intensive care unit |
| url | https://jidc.org/index.php/journal/article/view/19914 |
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