Evidence map›Paper›PMID 35839546›Full record

ArticleHeart & lung : the journal of critical care

"Ventilator-free days" composite outcome in patients with SARS-CoV-2 infection treated with tocilizumab: A retrospective competing risk analysis.

Ahmed F Mady, Basheer Abdulrahman, Shahzad A Mumtaz, Mohammed A Al-Odat, Ahmed Kuhail, Rehab Altoraifi, Rayan Alshae, Abdulrahman M Alharthy, Waleed Th Aletreby

Abstract read
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Article in Heart & lung : the journal of critical care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ahmed F MadyCritical Care Department, King Saud Medical City, Riyadh, Saudi Arabia; Anesthesia Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Basheer AbdulrahmanCritical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
Shahzad A MumtazCritical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
Mohammed A Al-OdatCritical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
Ahmed KuhailCritical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
Rehab AltoraifiCritical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
Rayan AlshaeCritical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
Abdulrahman M AlharthyCritical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
Waleed Th AletrebyCritical Care Department, King Saud Medical City, Riyadh, Saudi Arabia. Electronic address: wthashim@ksmc.med.sa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSARS-CoV-2 infection demonstrates a wide range of severity, with more severe cases presenting with a cytokine storm with elevated serum interleukin-6; hence, the interleukin-6 receptor antibody tocilizumab was used for the management of severe cases.

objectiveTo explore the effect of tocilizumab on ventilator-free day composite outcomes among critically ill patients with SARS-CoV-2 infection.

methodsThis retrospective propensity score-matching study compared mechanically ventilated patients who received tocilizumab to a control group.

resultsTwenty-nine patients in the intervention group were compared to 29 controls. The matched groups were similar. The ventilator-free days composite outcome was higher in the intervention group (sub-distribution hazard ratio 2.7, 95% confidence interval [CI]: 1.2-6.3; p = 0.02), the mortality rate in the intensive care unit was not different (37.9% vs 62%, p = 0.1), and actual ventilator-free days were significantly longer in the tocilizumab group (mean difference 4.7 days; p = 0.02). Sensitivity analysis showed a significantly lower hazard ratio for death in the tocilizumab group (HR 0.49, 95% CI: 0.25-0.97; p = 0.04). Positive cultures were not significantly different among the groups (55.2% vs 34.5% in the tocilizumab and control groups, respectively; p = 0.1).

conclusionsTocilizumab may improve the composite outcome of ventilator-free days at day 28 among mechanically ventilated patients with SARS-CoV-2 infection. It is associated with significantly longer actual ventilator-free days, insignificantly lower mortality, and higher superinfection.

Indexed as

COVID-19Antibodies, Monoclonal, HumanizedCOVID-19 Drug TreatmentHumansInterleukin-6Receptors, Interleukin-6Respiration, ArtificialRetrospective StudiesRisk AssessmentSARS-CoV-2Treatment OutcomeAntibodies, Monoclonal, HumanizedInterleukin-6Receptors, Interleukin-6tocilizumabMechanical ventilationSARS-CoV-2TocilizumabVentilator-free days

Identifiers

PMID35839546
PMCPMC9242887

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.