The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected over 3 million people worldwide with an estimated mortality rate of 5%. Owing to the diversity of training and the variety of positions within the pharmacy department, pharmacists are uniquely positioned in the hospital setting to play a pivotal role during the pandemic. The purpose of this article is to highlight the experiences and impactful interventions made by pharmacists practicing in a community teaching hospital at the center of the COVID-19 surge in New York City. Although often underrecognized, pharmacists are well-equipped to develop treatment plans based on the evolving literature that positively affect the patient outcomes by responding to inpatient emergencies, and optimizing the medication orders to conserve and maintain a healthy supply of medications for the hospital.
AimsThis study aimed to investigate the potential of tocilizumab therapy in minimizing mortality and mechanical ventilation (MV) requirements among hospitalized COVID-19 patients.MethodsA single-center, retrospective, observational cohort study of 375 patients with severe COVID-19 (from March 1 to April 22, 2020) included 150 patients treated with tocilizumab and 225 consecutive control patients adjusted for age and sex. Both groups received concomitant standard of care treatments in addition to tocilizumab. The statistical methods relied on survival analyses, conditional logistic regression models, and contingency analyses. The outcomes included in-hospital mortality and the MV requirement.ResultsTocilizumab associated with improved in-hospital mortality (34.7% vs 46.7%, P = 0.0136) and lower requirement for MV on days 1, 3, and 5 after treatment (P = 0.005, P < 0.0001, and P = 0.0021, respectively). Lower mortality was observed if tocilizumab was administered within 48 hours after admission (P = 0.0226). Older age and low blood oxygen saturation on admission decreased the odds of survival (P < 0.005).ConclusionsOur study demonstrates a significant reduction in mortality and decreased requirement of MV with tocilizumab treatment in addition to the standard of care. Early administration of tocilizumab within 48 hours reduces the risk of mortality.
Aims
This study aimed to investigate the potential of tocilizumab therapy in minimizing mortality and mechanical ventilation (MV) requirements among hospitalized COVID-19 patients.
Methods
A single-center, retrospective, observational cohort study of 375 patients with severe COVID-19 (March 1 and April 22, 2020) included 150 patients treated with Tocilizumab and 225 consecutive control patients adjusted for age and gender. Both groups received concomitant standard of care treatments in addition to Tocilizumab. The statistical methods relied on survival analyses, conditional logistic regression models, and contingency analyses. The primary outcomes included in-hospital mortality and the MV requirement.
Results
Tocilizumab associated with improved in-hospital mortality (34.7% vs 46.7%, P = 0.0136) and lower requirement for MV on days 1, 3, and 5 after treatment (P = 0.005, P < 0.0001, and P = 0.0021, respectively). Lower mortality was observed if tocilizumab was administered within 48 hours after admission (P = 0.0226). Older age and low blood oxygen saturation on admission decreased the odds of survival (P < 0.005).
Conclusion
Our study demonstrates a significant reduction in mortality and decreased requirement of MV with tocilizumab treatment in addition to the standard of care. Early administration of Tocilizumab within 48 hours reduces the risk of mortality.
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