@article{10902/21817,
year = {2020},
url = {http://hdl.handle.net/10902/21817},
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.},
publisher = {Wiley Periodicals Inc.},
publisher = {Am J Transplant. 2020 Nov;20(11):3182-3190},
title = {Use of tocilizumab in kidney transplant recipients with COVID-1},
author = {Pérez Sáez, María J and Blasco, Miquel and Redondo Pachón, Dolores and Ventura Aguiar, Pedro and Bada Bosch, Teresa and Pérez Florez, Isabel and Melilli, Edoardo and Sánchez Cámara, Luis A and López Oliva, María O and Canal, Cristina and Shabaka, Amir and Garra Moncau, Nuria and Martín Moreno, Paloma L and López, Verónica and Hernández Gallego, Román and Siverio, Orlando and Galeano, Cristina and Espí Reig, Jordi and Cabezas, Carlos J and Rodrigo, María T and Llinás Mallol, Laura and Fernandez Reyes, María J and Cruzado Vega, Leónidas and Pérez Tamajón, Lourdes and Santana Estupiñán, Raquel and Ruiz Fuentes, María C and Tabernero, Guadalupe and Zárraga, Sofía and Ruiz San Millán, Juan Carlos},
}