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Rojas-Marte G, Khalid M, Mukhtar O, Hashmi AT, Waheed MA, Ehrlich S, Aslam A, Siddiqui S, Agarwal C, Malyshev Y, Henriquez-Felipe C, Sharma D, Sharma S, Chukwuka N, Rodriguez DC, Alliu S, Le J, Shani J. Corrigendum to: Outcomes in patients with severe COVID-19 disease treated with tocilizumab: a case-controlled study. QJM 2023; 116:733. [PMID: 33447849 PMCID: PMC8108631 DOI: 10.1093/qjmed/hcaa266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G Rojas-Marte
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
- Department of Cardiology, Staten Island University
Hospital-Northwell Health, 475 Seaview Avenue, Staten Island, NY
10305, USA
| | - M Khalid
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - O Mukhtar
- Department of Pulmonology, Interfaith Medical
Center, 1545 Atlantic Avenue, Brooklyn, NY 11213, USA and
| | - A T Hashmi
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - M A Waheed
- Department of Internal Medicine, Maimonides Medical
Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - S Ehrlich
- Department of Internal Medicine, Maimonides Medical
Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - A Aslam
- Department of Internal Medicine, Maimonides Medical
Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - S Siddiqui
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - C Agarwal
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - Y Malyshev
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - C Henriquez-Felipe
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - D Sharma
- Department of Internal Medicine, Maimonides Medical
Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - S Sharma
- Department of Internal Medicine, Maimonides Medical
Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - N Chukwuka
- Department of Internal Medicine, Maimonides Medical
Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - D C Rodriguez
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - S Alliu
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - J Le
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - J Shani
- From the Department of Cardiology, Maimonides
Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
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Raheja H, Chukwuka N, Agarwal C, Sharma D, Munoz-Martinez A, Fogel J, Khalid M, Hashmi AT, Ehrlich S, Waheed MA, Siddiqui S, de Brito Gomes BA, Aslam A, Merino Gualan CJ, Aftab I, Tiwari A, Singh S, Pouching K, Somal N, Shani J, Rojas-Marte G. Should COVID-19 patients >75 years be Ventilated? An Outcome Study. QJM 2021; 114:182-189. [PMID: 33580251 PMCID: PMC7928642 DOI: 10.1093/qjmed/hcab029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/02/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Elderly patients with COVID-19 disease are at increased risk for adverse outcomes. Current data regarding disease characteristics and outcomes in this population are limited. AIM To delineate the adverse factors associated with outcomes of COVID-19 patients ≥75 years of age. DESIGN Retrospective cohort study. METHODS Patients were classified into mild/moderate, severe/very severe and critical disease (intubated) based on oxygen requirements. The primary outcome was in-hospital mortality. RESULTS A total of 355 patients aged ≥75 years hospitalized with COVID-19 between 19 March and 25 April 2020 were included.Mean age was 84.3 years. One-third of the patients developed critical disease. Mean length of stay was 7.10 days. Vasopressors were required in 27%, with the highest frequency in the critical disease group (74.1%). Overall mortality was 57.2%, with a significant difference between severity groups (mild/moderate disease: 17.4%, severe/very severe disease: 71.3%, critical disease: 94.9%, P < 0.001).Increased age, dementia, and severe/very severe and critical disease groups were independently associated with increased odds for mortality while diarrhea was associated with decreased odds for mortality (OR: 0.12, 95% CI: 0.02-0.60, P < 0.05). None of the cardiovascular comorbidities were significantly associated with mortality. CONCLUSION Age and dementia are associated with increased odds for mortality in patients ≥75 years of age hospitalized with COVID-19. Those who require intubation have the greatest odds for mortality. Diarrhea as a presenting symptom was associated with lower odds for mortality.
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Affiliation(s)
- H Raheja
- Department of Cardiology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA
| | - N Chukwuka
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - C Agarwal
- Department of Cardiology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA
| | - D Sharma
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - A Munoz-Martinez
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - J Fogel
- Department of Business Management, Brooklyn College, Brooklyn, NY, USA
| | - M Khalid
- Department of Cardiology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA
| | - A T Hashmi
- Department of Cardiology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA
| | - S Ehrlich
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - M A Waheed
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - S Siddiqui
- Department of Cardiology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA
| | - B A de Brito Gomes
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - A Aslam
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - C J Merino Gualan
- Department of Volunteer and Student Services, Maimonides Medical Center, Brooklyn, NY, USA
| | - I Aftab
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - A Tiwari
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - S Singh
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - K Pouching
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - N Somal
- Department of Internal Medicine, Maimonides Medical Center, 475 Seaview Avenue, Staten Island NY 10305, USA
| | - J Shani
- Department of Cardiology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA
| | - G Rojas-Marte
- Department of Cardiology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Staten Island, NY, USA
- Address correspondence to Geurys R Rojas-Marte, M.D., Department of Cardiology, Maimonides Medical Center, Assistant Professor of Cardiology, Zucker School of Medicine at Hosftra/Northwell, 4802 10th Ave, Brooklyn, NY, USA.
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Rojas-Marte G, Khalid M, Mukhtar O, Hashmi AT, Waheed MA, Ehrlich S, Aslam A, Siddiqui S, Agarwal C, Malyshev Y, Henriquez-Felipe C, Sharma D, Sharma S, Chukwuka N, Rodriguez DC, Alliu S, Le J, Shani J. Outcomes in patients with severe COVID-19 disease treated with tocilizumab: a case-controlled study. QJM 2020; 113:546-550. [PMID: 32569363 PMCID: PMC7337835 DOI: 10.1093/qjmed/hcaa206] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/10/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19 is an ongoing threat to society. Patients who develop the most severe forms of the disease have high mortality. The interleukin-6 inhibitor tocilizumab has the potential to improve outcomes in these patients by preventing the development of cytokine release storm. AIMS To evaluate the outcomes of patients with severe COVID-19 disease treated with the interleukin-6 inhibitor tocilizumab. METHODS We conducted a retrospective, case-control, single-center study in patients with severe to critical COVID-19 disease treated with tocilizumab. Disease severity was defined based on the amount of oxygen supplementation required. The primary endpoint was the overall mortality. Secondary endpoints were mortality in non-intubated patients and mortality in intubated patients. RESULTS A total of 193 patients were included in the study. Ninety-six patients received tocilizumab, while 97 served as the control group. The mean age was 60 years. Patients over 65 years represented 43% of the population. More patients in the tocilizumab group reported fever, cough and shortness of breath (83%, 80% and 96% vs. 73%, 69% and 71%, respectively). There was a non-statistically significant lower mortality in the treatment group (52% vs. 62.1%, P = 0.09). When excluding intubated patients, there was statistically significant lower mortality in patients treated with tocilizumab (6% vs. 27%, P = 0.024). Bacteremia was more common in the control group (24% vs. 13%, P = 0.43), while fungemia was similar for both (3% vs. 4%, P = 0.72). CONCLUSION Our study showed a non-statistically significant lower mortality in patients with severe to critical COVID-19 disease who received tocilizumab. When intubated patients were excluded, the use of tocilizumab was associated with lower mortality.
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Affiliation(s)
- G Rojas-Marte
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
- Department of Cardiology, Staten Island University Hospital-Northwell Health, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - M Khalid
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - O Mukhtar
- Department of Pulmonology, Interfaith Medical Center, 1545 Atlantic Avenue, Brooklyn, NY 11213, USA
| | - A T Hashmi
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - M A Waheed
- Department of Internal Medicine, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - S Ehrlich
- Department of Internal Medicine, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - A Aslam
- Department of Internal Medicine, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - S Siddiqui
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - C Agarwal
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - Y Malyshev
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - C Henriquez-Felipe
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - D Sharma
- Department of Internal Medicine, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - S Sharma
- Department of Internal Medicine, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - N Chukwuka
- Department of Internal Medicine, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - D C Rodriguez
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - S Alliu
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - J Le
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
| | - J Shani
- Department of Cardiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
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Affiliation(s)
- G Rojas-Marte
- Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - S Chadha
- Department of Cardiology, Maimonides Medical Center, Brooklyn, NY, USA
| | - B Topi
- Department of Cardiology, Maimonides Medical Center, Brooklyn, NY, USA
| | - G Hollander
- Department of Cardiology, Maimonides Medical Center, Brooklyn, NY, USA
| | - J Shani
- Department of Cardiology, Maimonides Medical Center, Brooklyn, NY, USA
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