Background This study aimed to evaluate the effectiveness of tocilizumab in mechanically ventilated patients with coronavirus disease 2019 (COVID-19). Research design and methods This retrospective multicenter study included adults (≥18 years) diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time polymerase chain reaction (RT-PCR) from nasopharyngeal swab, and requiring invasive mechanical ventilation during admission. Survival analyses with inverse propensity score treatment weighting (IPTW) and propensity score matching (PSM) were conducted. To account for immortal bias, we used Cox proportional modeling with time-dependent covariance. Competing risk analysis was performed for the extubation endpoint. Results A total of 556 (tocilizumab = 193, control = 363) patients were included. Males constituted the majority of the participants (69.2% in tocilizumab arm,74.1% in control arm). Tocilizumab was not associated with a reduction in mortality with hazard ratio [(HR) = 0.82,95% confidence interval (95%CI): 0.62–1.10] in the Inverse propensity score weighting (IPTW) analysis and (HR = 0.86,95% CI: 0.64–1.16) in the PSM analysis. However, tocilizumab was associated with an increased rate of extubation (33.6%) compared to the control arm (11.9%); subdistributional hazards (SHR) = 3.1, 95% CI: 1.86–5.16). Conclusions Although tocilizumab was not found to be effective in reducing mortality, extubation rate while on mechanical ventilation was higher among tocilizumabtreatedgroup.
Background: The relationship between cancers and thromboembolic events is well established. In our study we aim to determine the burden of thromboembolic events in patients with solid tumors and identify the risk factors related to their development.Methods: Data on patients with solid tumors and thromboembolism between January 2013 and September 2014 were collected and analyzed. Results: During the studied period 174 patients were identified, 172 (98.9%) of which had venous thrombus embolism. 137 (79%) were diagnosed with deep vein thromboses and 67 (38.5%) with pulmonary embolisms. 84 (48.3%) were symptomatic and 90 (51.7) were incidental at diagnosis. The most common risk factors were female sex, high Body mass index, metastatic stage, colorectal and breast primaries, and anti-neoplastic therapy.Conclusion: Our study confirmed the high burden of thromboembolic events in cancer patients and the relevant risk factors associated with its development.
Background Coagulation disorders are frequently encountered among coronavirus disease 2019 [COVID-19]-infected patients, especially among those with more severe symptoms. This study aims to determine the incidence and risk factors of venous thromboembolism [VTE] in COVID-19 patients. Methods The retrospective observational Cohort study was conducted from March to July 2020. All adult patients [> 18 years old] with laboratory-confirmed COVID-19 were included. Laboratory data and real-time reverse transcriptase-polymerase chain reaction [rRT-PCR] for SARS-CoV-2 were obtained from medical records and correlated with those who developed VTE. Results In this study, 1024 patients were identified with confirmed COVID-19, of which 58 patients [5.7%] had VTE. In the bivariate analysis, VTE was associated with chronic kidney disease, hematological disorder, cancer, and high D-dimer > 0.50 mg/l. The analysis of the data showed that the number of patients diagnosed with cancer was significantly higher in the VTE group [8 patients, 13.8%] than the non-VTE group [47 patients, 4.9%; p = 0.003]. Patients with cancer were 2 times more likely to have VTE [adjusted odds ratio [1] = 2.614; 95% CI=[1.048–6.519]; p = 0.039]. The sensitivity analyses showed that individuals with high D-dimer > 0.50 mg/l were more likely to have VTE. Conclusion VTE is more prevalent among individuals with chronic conditions, including cancer. Healthcare professionals should closely monitor individuals with high risk of developing VTE, including those with COVID-19 and chronic conditions, to prevent unwanted complications.
Background Coagulation disorders are frequently encountered among coronavirus disease 2019 [COVID-19]-infected patients, especially among those with more severe symptoms. This study aims to determine the incidence and risk factors of venous thromboembolism [VTE] in COVID-19 patients.Methods The retrospective observational Cohort study was conducted from March to July 2020. All adult patients [>18 years old] with laboratory-confirmed COVID-19 were included. Laboratory data and real-time reverse transcriptase-polymerase chain reaction [rRT-PCR] for SARS-CoV-2 were obtained from medical records and correlated with those who developed VTE. Results In this study, 1024 patients were identified with confirmed COVID-19, of which 58 patients [5.7%] had VTE. In the bivariate analysis, VTE was associated with chronic kidney disease, hematological disorder, cancer, and high D-dimer>0.50 mg/l. The analysis of the data showed that the number of patients diagnosed with cancer was significantly higher in the VTE group [8 patients, 13.8%] than the non-VTE group [47 patients, 4.9%; p=0.003]. Patients with cancer were 2 times more likely to have VTE [adjusted odds ratio [1]=2.614; 95% CI=[1.048 – 6.519]; p=0.039]. The sensitivity analyses showed that individuals with high D-dimer>0.50 mg/l were more likely to have VTE.Conclusion VTE is more prevalent among individuals with chronic conditions, including cancer. Healthcare professionals should closely monitor individuals with high risk of developing VTE, including those with COVID-19 and chronic conditions, to prevent unwanted complications.
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