Coronavirus disease 2019 (COVID-19) can progress to cytokine storm that is associated with organ dysfunction and death. The purpose of the present study is to determine clinical characteristics associated with 28 day in-hospital survival in patients with coronavirus disease 2019 (COVID-19) that received tocilizumab. This was a retrospective observational cohort study conducted at a five hospital health system in Michigan, United States. Adult patients with confirmed COVID-19 that were admitted to the hospital and received tocilizumab for cytokine storm from March 1, 2020 through April 3, 2020 were included. Patients were grouped into survivors and non-survivors based on 28 day in-hospital mortality. Study day 0 was defined as the day tocilizumab was administered. Factors independently associated with in-hospital survival at 28 days after tocilizumab administration were assessed. Epidemiologic, demographic, laboratory, prognostic scores, treatment, and outcome data were collected and analyzed. Clinical response was collected and defined as a decline of two levels on a six-point ordinal scale of clinical status or discharged alive from the hospital. Of the 81 patients included, the median age was 64 (58–71) years and 56 (69.1%) were male. The 28 day in-hospital mortality was 43.2%. There were 46 (56.8%) patients in the survivors and 35 (43.2%) in the non-survivors group. On study day 0 no differences were noted in demographics, clinical characteristics, severity of illness scores, or treatments received between survivors and non-survivors. C-reactive protein was significantly higher in the non-survivors compared to survivors. Compared to non-survivors, recipients of tocilizumab within 12 days of symptom onset was independently associated with survival (adjusted OR: 0.296, 95% CI: 0.098–0.889). SOFA score ≥8 on day 0 was independently associated with mortality (adjusted OR: 2.842, 95% CI: 1.042–7.753). Clinical response occurred more commonly in survivors than non-survivors (80.4% vs. 5.7%; p < 0.001). Improvements in the six-point ordinal scale and SOFA score were observed in survivors after tocilizumab. Early receipt of tocilizumab in patients with severe COVID-19 was an independent predictor for in-hospital survival at 28 days.

冠状病毒病2019（COVID-19）可能发展为与器官功能障碍和死亡相关的细胞因子风暴。本研究的目的是确定与接受Tocilizumab治疗的2019年冠状病毒病（COVID-19）患者的28天院内生存期相关的临床特征。这是一项在美国密歇根州的五家医院卫生系统进行的回顾性观察队列研究。纳入了从2020年3月1日至2020年4月3日入院并接受托珠单抗治疗的细胞因子风暴的确诊COVID-19的成年患者。根据28天住院死亡率将患者分为幸存者和非幸存者。研究第0天定义为给予托珠单抗的当天。评估了与托珠单抗给药后28天的院内生存独立相关的因素。收集并分析了流行病学，人口统计学，实验室，预后评分，治疗和结局数据。收集临床反应并将其定义为临床状况的六点顺序量表下降两个水平或活着出院。在包括的81名患者中，中位年龄为64（58-71）岁，男性为56（69.1％）。28天住院死亡率为43.2％。幸存者中有46名（56.8％）患者，非幸存者组中有35名（43.2％）。在研究的第0天，幸存者和非幸存者之间的人口统计学，临床特征，疾病评分的严重性或所接受的治疗均无差异。与幸存者相比，非幸存者中的C反应蛋白明显更高。与非幸存者相比，在症状发作后12天内接受tocilizumab的患者与生存独立相关（校正OR：0.296，95％CI：0.098-0.889）。第0天的SOFA得分≥8与死亡率独立相关（校正OR：2.842，95％CI：1.042-7.753）。幸存者比非幸存者更常见发生临床反应（80.4％vs. 5.7％； p <0.001）。托珠单抗治疗后的幸存者中观察到六点顺序量表和SOFA评分有所改善。重度COVID-19患者应及早接受tocilizumab治疗，这是其28天住院生存率的独立预测指标。症状发作后12天内接受tocilizumab的患者与生存独立相关（校正OR：0.296，95％CI：0.098-0.889）。第0天的SOFA得分≥8与死亡率独立相关（校正OR：2.842，95％CI：1.042-7.753）。幸存者的临床反应比非幸存者更为常见（80.4％vs. 5.7％； p <0.001）。托珠单抗治疗后的幸存者中观察到六点顺序量表和SOFA评分有所改善。重度COVID-19患者应及早接受tocilizumab治疗，这是其28天住院生存率的独立预测指标。症状发作后12天内接受tocilizumab的患者与生存独立相关（校正OR：0.296，95％CI：0.098-0.889）。第0天的SOFA得分≥8与死亡率独立相关（校正OR：2.842，95％CI：1.042-7.753）。幸存者的临床反应比非幸存者更为常见（80.4％vs. 5.7％； p <0.001）。托珠单抗治疗后的幸存者中观察到六点顺序量表和SOFA评分有所改善。重度COVID-19患者应及早接受tocilizumab治疗，这是其28天住院生存率的独立预测指标。托珠单抗治疗后的幸存者中观察到六点顺序量表和SOFA评分有所改善。重度COVID-19患者应及早接受tocilizumab治疗，这是其28天住院生存率的独立预测指标。托珠单抗治疗后的幸存者中观察到六点顺序量表和SOFA评分有所改善。重度COVID-19患者应及早接受tocilizumab治疗，这是其28天住院生存率的独立预测指标。