Inmunosupresión vs. Inmunorregulación en COVID-19
Resumen
La COVID-19 tiene un espectro clínico variable, desde una infección asintomática hasta una enfermedad crítica con desenlace mortal. Se han propuesto múltiples terapias, algunas con efectos a nivel de la respuesta inmunológica. En este estudio evaluamos el uso de Tocilizumab, Colchicina y Baricitinib en pacientes hospitalizados con infección por SARS-CoV-2. Se examinaron los expedientes clínicos de 133 pacientes hospitalizados con COVID-19 en 3 hospitales. Inicialmente, ninguno de estos medicamentos mostró ser superior al grupo Control en disminuir la mortalidad. Sin embargo, se realizó un análisis estratificado evidenciando que Tocilizumab puede reducir la mortalidad hasta un 3.7% vs 28.12% (p=0.01). La estancia intrahospitalaria fue mayor en los pacientes que recibieron Baricitinib y Tocilizumab comparados con el Control (14.25±2.06 y 10.58±3.66 respectivamente vs 8.30±2.86). Finalmente, Tocilizumab fue el único fármaco que redujo la probabilidad de un aumento en el requerimiento de oxígeno suplementario (OR 0.3094, 0.95% IC [0.1031-0.9287]). La terapia inmunorreguladora muestra ser útil para el manejo de pacientes con COVID-19.
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