Comparing efficacy and safety of tocilizumab and methylprednisolone in the treatment of patients with severe COVID-19

Abbasian, Ladan; Toroghi, Negar; Rahmani, Hamid Reza; Khalili, Hossein; Hasannezhad, Malihe; Ghiasvand, Fereshteh; Jafari, Sirous; Salehi, Mohammadreza; Salahshour, Faeze; Gorabi, Mahsa Azadbakhsh Kanaf; Alizade, Fateme; Ghaderkhani, Sara; Nakhostin, Maryam

doi:10.1016/j.intimp.2022.108689

Cited by 2 publications

(3 citation statements)

References 31 publications

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“…Although there is a relationship between the clinical and radiological severity of COVID‐19 and the serum CRP level in various previous studies, the definitive cut‐off has not been clearly presented until now 10,26,48–50 . One of the important topics in the management and treatment of patients with severe COVID‐19 is the time of prescription of anti‐inflammatory agents such as corticosteroids and IL‐6 antagonists for cytokine storm controlling 51–53 . In various guidelines and studies, some respiratory, radiological and laboratory markers have been mentioned to express the severity of COVID‐19 and the initiation of anti‐inflammatory therapy, of which the most important and common index is the level of serum CRP 54–56 .…”

Section: Discussionmentioning

confidence: 99%

“… 10 , 26 , 48 , 49 , 50 One of the important topics in the management and treatment of patients with severe COVID‐19 is the time of prescription of anti‐inflammatory agents such as corticosteroids and IL‐6 antagonists for cytokine storm controlling. 51 , 52 , 53 In various guidelines and studies, some respiratory, radiological and laboratory markers have been mentioned to express the severity of COVID‐19 and the initiation of anti‐inflammatory therapy, of which the most important and common index is the level of serum CRP. 54 , 55 , 56 Within RECOVERY Collaborative Group, one of the inclusion criteria to receive tocilizumab or the standard of care was CRP ≥ 75 mg/L as a marker of systemic inflammation, which is interestingly consistent with the cutoff we obtained in our study.…”

Section: Discussionmentioning

confidence: 99%

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Serum C‐reactive protein greater than 75 mg/dL as an early available laboratory predictor of severe COVID‐19: A systematic review

Nazemi,

SeyedAlinaghi,

Azarnoush

et al. 2023

Immunity Inflam & Disease

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IntroductionSevere COVID‐19 management is still challenging. Having a laboratory factor to predict the severity of a patient's condition can be very useful in how to approach each patient. There have been studies concentrating on the correlation between serum C‐reactive protein (CRP) level and COVID‐19 severity but we aim to reach a threshold for CRP in disease severity determination.MethodsWe conducted a thorough search on PubMed, Web of Science and Google Scholar databases from early 2019 to October 2021, and 323 studies were assessed for eligibility in three phases. We used the Newcastle‐Ottawa Scale to examine the validity of the studies. The t‐test was applied for the CRP level cutoffs.ResultsEventually, 11 articles and 1615 patients were included in this systematic review. Our analysis evaluated combined mean, median, and standard deviation of severe patients' CRP to be respectively 73.37, 53.80, and 47.936. Based on the combined mean, 75 mg/dL was suggested as an initial threshold for baseline CRP in hospitalized patients for developing severe conditions.ConclusionThis study recommends that COVID‐19 patients with on‐admission serum CRP levels of 75 mg/dL and more are likely associated with severe conditions. Thus, anti‐inflammatory agents and further following may be helpful in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Serum C‐reactive protein greater than 75 mg/dL as an early available laboratory predictor of severe COVID‐19: A systematic review

Nazemi,

SeyedAlinaghi,

Azarnoush

et al. 2023

Immunity Inflam & Disease

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“…Several antiviral drugs and anti-inflammatory agents were examined for the treatment of COVID-19 patients, but they were unsuccessful [68][69][70]. At the beginning of the pandemic, corticosteroids were prescribed by many clinical teams to treat hospitalized COVID-19 patients, but after the publication of the successful results of recovery trials, the administration of dexamethasone was introduced to most therapeutic protocols to save hospitalized patients [71,72]. Finally, in many critical patients with COVID-19, the high doses of corticosteroids (pulse therapy) were prescribed [73,74].…”

Section: Covid-19 Associated Pulmonary Aspergillosis (Capa)mentioning

confidence: 99%

Post-Viral Aspergillosis

Salehi¹,

Zamani²,

Khodavaisy³

2023

Infectious Diseases

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Post-viral aspergillosis (PVA) is a clinical form of Aspergillus infection that occurs after some viral infections. Aspergillus is the most common respiratory fungal co-pathogen in patients with viral infections. Most cases of PVA have been reported as invasive pulmonary aspergillosis (IPA) after influenza, COVID-19, and the cytomegalovirus infection. PVA is more commonly reported in critically ill patients with viral pneumonia. Suggested risk factors for PVA include cellular immune deficiency, ARDS, pulmonary tracts and parenchyma damage, and corticosteroid therapy. New pulmonary nodules such as dense, well-circumscribed lesions with or without a halo sign, air crescent sign, or cavity, or wedge-shaped and segmental or lobar consolidation on the chest CT scan can suggest PVA. As in the treatment of invasive aspergillosis in other settings, triazoles, such as voriconazole or isavuconazole, have been suggested as the first-line treatment for PVA. It seems that the presence of PVA has significantly decreased the survival rate in patients with viral infections.

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Comparing efficacy and safety of tocilizumab and methylprednisolone in the treatment of patients with severe COVID-19

Cited by 2 publications

References 31 publications

Serum C‐reactive protein greater than 75 mg/dL as an early available laboratory predictor of severe COVID‐19: A systematic review

Serum C‐reactive protein greater than 75 mg/dL as an early available laboratory predictor of severe COVID‐19: A systematic review

Post-Viral Aspergillosis

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