The association between tocilizumab and the secondary bloodstream infection maybe nonsignificant in hospitalized patients with SARS-CoV-2 infection: A cohort study

De En Lu, Tsong Yih Ou, Jyun Wei Kang, Jie Ywi Ong, I. Ju Chen, Chih Hsin Lee, Ming Chia Lee

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Immunomodulatory agents, such as tocilizumab (TCZ), exert promising effects against SARS-CoV-2 infection. However, growing evidence indicates that using TCZ may carry higher risks of secondary bloodstream infection (sBSI). This study determined whether TCZ is associated with an increased risk of sBSI. Methods: We retrospectively collected the demographic and clinical data of hospitalized patients with SARS-CoV-2 infection from two Taiwanese hospitals. The time-to-incident sBSI in the TCZ users and nonusers was compared using the log-rank test. A multivariate Cox proportional hazards model was performed to identify independent risk factors for sBSI. Results: Between May 1 and August 31, 2021, among 453 patients enrolled, 12 (2.65 %) developed sBSI. These patients were in hospital for longer duration (44.2 ± 31.4 vs. 17.6 ± 14.3 days, p = 0.014). Despite sBSI being more prevalent among the TCZ users (7.1 % vs. 1.6 %, p = 0.005), Kaplan–Meier survival analysis and multivariate Cox proportional hazards model both revealed no significant difference in risks of sBSI between the TCZ users and nonusers [adjusted HR (aHR) = 1.32 (95 % confidence interval (CI) = 0.29–6.05), p = 0.724]. Female sex [aHR = 7.00 (95 % CI = 1.45–33.92), p = 0.016], heavy drinking [aHR = 5.39 (95 % CI = 1.01–28.89), p = 0.049], and mechanical ventilation [aHR = 5.65 (95 % CI = 1.67–19.30), p = 0.006] were independently associated with a higher sBSI risk. Conclusion: This real-world evidence indicates that in hospitalized patients with SARS-CoV-2 infection, TCZ does not significantly increase the risk of sBSI.

Original languageEnglish
Pages (from-to)38-47
Number of pages10
JournalJournal of Microbiology, Immunology and Infection
Volume57
Issue number1
DOIs
Publication statusPublished - Feb 2024

Keywords

  • SARS-CoV-2 infection
  • Secondary bloodstream infections
  • Tocilizumab

ASJC Scopus subject areas

  • Immunology and Allergy
  • General Immunology and Microbiology
  • Microbiology (medical)
  • Infectious Diseases

Fingerprint

Dive into the research topics of 'The association between tocilizumab and the secondary bloodstream infection maybe nonsignificant in hospitalized patients with SARS-CoV-2 infection: A cohort study'. Together they form a unique fingerprint.

Cite this