Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study

Aljuhani, Ohoud; Sulaiman, Khalid Al; Alshabasy, Adel; Eljaaly, Khalid; Shaya, Abdulrahman I Al; Noureldeen, Haytham; Aboudeif, Mohammed M; Dosari, Bodoor Al; Alkhalaf, Amina; Korayem, Ghazwa B.; Aleissa, Muneera M.; Badreldin, Hisham A.; Harbi, Shmeylan Al; Alhammad, Abdullah; Vishwakarma, Ramesh

doi:10.1186/s12879-021-06813-1

Cited by 9 publications

(4 citation statements)

References 39 publications

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“…This study was carried out under the auspices of the Saudi Critical Care Pharmacy Research (SCAPE) platform, which also conducted other investigations to evaluate the safety and effectiveness of various therapies in critically ill patients ( SCAPE, n.d. ). The methodology of this multicenter cohort study is comparable to other studies executed by the SCAPE platform and previously reported ( Al Harbi et al, 2022 , Al Sulaiman et al, 2022b , Al Sulaiman et al, 2022a , Al Sulaiman et al, 2021a , Al Sulaiman et al, 2021b , Aljuhani et al, 2021 ). The supplemental material contains additional details on the study's design.…”

Section: Methodssupporting

confidence: 59%

Ketamine-based Sedation Use in Mechanically Ventilated Critically Ill Patients with COVID-19: A Multicenter Cohort Study

Aljuhani,

Al Sulaiman,

Korayem

et al. 2024

Saudi Pharmaceutical Journal

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Section: Methodssupporting

confidence: 59%

Ketamine-based Sedation Use in Mechanically Ventilated Critically Ill Patients with COVID-19: A Multicenter Cohort Study

Aljuhani,

Al Sulaiman,

Korayem

et al. 2024

Saudi Pharmaceutical Journal

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“…Our results showed no difference in the length of stay; similarly, a systematic review and metaanalysis by Rezaei et al showed no statistically significant difference in hospital length of stay. 17 We believe our study is one of the first studies that suggest a potential role of TCZ in preventing multiorgan dysfunction in critically ill patients with COVID-19 if further confirmed in large RCTs. The aforementioned trials studied organ dysfunction in terms of respiratory and cardiovascular organ support free day in the REMAB-CAP and receiving mechanical ventilation or hemofiltration in the RECOVERY trial while our study measured the MOD score which accounts for the severity of MOD in six organ systems including respiratory, cardiovascular, renal, hematological, hepatic failure, and central nervous system.…”

Section: Discussionmentioning

confidence: 54%

“…Our results showed no difference in the length of stay; similarly, a systematic review and meta-analysis by Rezaei et al showed no statistically significant difference in hospital length of stay. 17 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of Early Tocilizumab Effect on Multiorgan Dysfunction in Critically Ill Patients With COVID-19: A Propensity Score-Matched Study

Aljuhani

Korayem

Altebainawi

et al. 2023

J Intensive Care Med

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Background: Tocilizumab (TCZ) has been proposed as potential rescue therapy for severe COVID-19. No previous study has primarily assessed the role of TCZ in preventing severe COVID-19-related multiorgan dysfunction. Hence, this multicenter cohort study aimed to evaluate the effectiveness of TCZ early use versus standard of care in preventing severe COVID-19-related multiorgan dysfunction in COVID-19 critically ill patients during intensive care unit (ICU) stay. Methods: A multicenter, retrospective cohort study includes critically ill adult patients with COVID-19 admitted to the ICUs. Patients were categorized into two groups, the treatment group includes patients who received early TCZ therapy within 24 hours of ICU admission and the control group includes patients who received standard of care. The primary outcome was the multiorgan dysfunction on day three of the ICU admission. The secondary outcomes were 30-day, and in-hospital mortality, ventilator-free days, hospital length of stay (LOS), ICU LOS, and ICU-related complications. Results: After propensity score matching, 300 patients were included in the analysis based on predefined criteria with a ratio of 1:2. Patients who received TCZ had lower multiorgan dysfunction score on day three of ICU admission compared to the control group (beta coefficient: −0.13, 95% CI: −0.26, −0.01, P-value = 0.04). Moreover, respiratory failure requiring MV was statistically significantly lower in patients who received early TCZ compared to the control group (OR 0.52; 95% CI 0.31, 0.91, P-value = 0.02). The 30-day and in-hospital mortality were significantly lower in patients who received TCZ than those who did not (HR 0.56; 95% CI 0.37, 0.85, P-value = 0 .006 and HR 0.54; 95% CI 0.36, 0.82, P-value = 0.003, respectively). Conclusion: In addition to the mortality benefits associated with early TCZ use within 24 hours of ICU admission, the use of TCZ was associated with a significantly lower multiorgan dysfunction score on day three of ICU admission in critically ill patients with COVID-19.

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“…Patients who received vitamin D have a statistically significant longer MV duration than patients who did not [median (Q1, Q3) 12 ( 6 , 20 ) vs. 9 ( 3 , 16 ) days; P = <0.01]. The regression analysis was also significantly longer [beta coefficient 0.24 (95% CI 0.00, 0.47), P = 0.05].…”

Section: Resultsmentioning

confidence: 99%

Survival implications vs. complications: unraveling the impact of vitamin D adjunctive use in critically ill patients with COVID-19—A multicenter cohort study

Al Sulaiman,

Korayem,

Aljuhani

et al. 2023

Front. Med.

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BackgroundDespite insufficient evidence, vitamin D has been used as adjunctive therapy in critically ill patients with COVID-19. This study evaluates the effectiveness and safety of vitamin D as an adjunctive therapy in critically ill COVID-19 patients.MethodsA multicenter retrospective cohort study that included all adult COVID-19 patients admitted to the intensive care units (ICUs) between March 2020 and July 2021. Patients were categorized into two groups based on their vitamin D use throughout their ICU stay (control vs. vitamin D). The primary endpoint was in-hospital mortality. Secondary outcomes were the length of stay (LOS), mechanical ventilation (MV) duration, and ICU-acquired complications. Propensity score (PS) matching (1:1) was used based on the predefined criteria. Multivariable logistic, Cox proportional hazards, and negative binomial regression analyses were employed as appropriate.ResultsA total of 1,435 patients were included in the study. Vitamin D was initiated in 177 patients (12.3%), whereas 1,258 patients did not receive it. A total of 288 patients were matched (1:1) using PS. The in-hospital mortality showed no difference between patients who received vitamin D and the control group (HR 1.22, 95% CI 0.87–1.71; p = 0.26). However, MV duration and ICU LOS were longer in the vitamin D group (beta coefficient 0.24 (95% CI 0.00–0.47), p = 0.05 and beta coefficient 0.16 (95% CI −0.01 to 0.33), p = 0.07, respectively). As an exploratory outcome, patients who received vitamin D were more likely to develop major bleeding than those who did not [OR 3.48 (95% CI 1.10, 10.94), p = 0.03].ConclusionThe use of vitamin D as adjunctive therapy in COVID-19 critically ill patients was not associated with survival benefits but was linked with longer MV duration, ICU LOS, and higher odds of major bleeding.

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Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study

Cited by 9 publications

References 39 publications

Ketamine-based Sedation Use in Mechanically Ventilated Critically Ill Patients with COVID-19: A Multicenter Cohort Study

Ketamine-based Sedation Use in Mechanically Ventilated Critically Ill Patients with COVID-19: A Multicenter Cohort Study

Evaluation of Early Tocilizumab Effect on Multiorgan Dysfunction in Critically Ill Patients With COVID-19: A Propensity Score-Matched Study

Survival implications vs. complications: unraveling the impact of vitamin D adjunctive use in critically ill patients with COVID-19—A multicenter cohort study

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