Immunosuppression vs Immunoregulation in COVID-19
Abstract
COVID-19 has a variable clinical spectrum, from an asymptomatic infection to a critical illness with a fatal outcome. Multiple therapies have been proposed, some with effects at the immune response. In this study we evaluated the use of Tocilizumab, Colchicine and Baricitinib in hospitalized patients with SARS-CoV-2 infection. The medical records of 133 hospitalized patients with COVID-19 in 3 hospitals were examined. Initially, none of these drugs was shown to be superior to the Control group in reducing mortality. However, a stratified analysis was performed showing that Tocilizumab can reduce mortality up to 3.7% vs 28.12% (p = 0.01). The hospital stay was longer in the patients who received Baricitinib and Tocilizumab compared to the Control (14.25 ± 2.06 and 10.58 ± 3.66 respectively vs 8.30 ± 2.86). Finally, Tocilizumab was the only drug that reduced the probability of an increase in supplemental oxygen requirement (OR 0.3094, 0.95% CI [0.1031-0.9287]). Immunoregulatory therapy proves useful for the management of COVID-19 patients.
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