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Use of tocilizumab in kidney transplant recipients with COVID-1

Abstract: Acute respiratory distress syndrome associated with coronavirus infection is related to a cytokine storm with large interleukin-6 (IL-6) release. The IL-6-receptor blocker tocilizumab may control the aberrant host immune response in patients with coronavirus disease 2019 (COVID-19) . In this pandemic, kidney transplant (KT) recipients are a high-risk population for severe infection and showed poor outcomes. We present a multicenter cohort study of 80 KT patients with severe COVID-19 treated with tocilizumab during hospital admission. High mortality rate was identified (32.5%), related with older age (hazard ratio [HR] 3.12 for those older than 60 years, P = .039). IL-6 and other inflammatory markers, including lactic acid dehydrogenase, ferritin, and D-dimer increased early after tocilizumab administration and their values were higher in nonsurvivors. Instead, C-reactive protein (CRP) levels decreased after tocilizumab, and this decrease positively correlated with survival (mean 12.3 mg/L in survivors vs. 33 mg/L in nonsurvivors). Each mg/L of CRP soon after tocilizumab increased the risk of death by 1% (HR 1.01 [confidence interval 1.004-1.024], P = .003). Although patients who died presented with worse respiratory situation at admission, this was not significantly different at tocilizumab administration and did not have an impact on outcome in the multivariate analysis. Tocilizumab may be effective in controlling cytokine storm in COVID-19 but randomized trials are needed.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Am J Transplant. 2020 Nov;20(11):3182-3190

Editorial: Wiley Periodicals Inc.

 Año de publicación: 2020

Nº de páginas: 9

Tipo de publicación: Artículo de Revista

 DOI: 10.1111/ajt.16192

ISSN: 1600-6135,1600-6143

Url de la publicación: https://onlinelibrary.wiley.com/doi/full/10.1111/ajt.16192

Autores/as

PÉREZ SÁEZ, MARÍA J

BLASCO, MIQUEL

REDONDO PACHÓN, DOLORES

VENTURA AGUIAR, PEDRO

BADA BOSCH, TERESA

PÉREZ FLOREZ, ISABEL

MELILLI, EDOARDO

SÁNCHEZ CÁMARA, LUIS A

LÓPEZ OLIVA, MARÍA O

CANAL, CRISTINA

SHABAKA, AMIR

GARRA MONCAU, NURIA

MARTÍN MORENO, PALOMA L

LÓPEZ, VERÓNICA

HERNÁNDEZ GALLEGO, ROMÁN

SIVERIO, ORLANDO

GALEANO, CRISTINA

ESPÍ REIG, JORDI

CABEZAS, CARLOS J

RODRIGO, MARÍA T

LLINÁS MALLOL, LAURA

FERNANDEZ REYES, MARÍA J

CRUZADO VEGA, LEÓNIDAS

PÉREZ TAMAJÓN, LOURDES

SANTANA ESTUPIÑÁN, RAQUEL

RUIZ FUENTES, MARÍA C

TABERNERO, GUADALUPE

ZÁRRAGA, SOFÍA

JUAN CARLOS RUIZ SAN MILLAN