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<p>During severe and critical COVID-19, therapeutic options remain scarce. Among interventions, the use of interleukin-6 receptor inhibitor (IL-6Ri) is especially controversial due to persistent uncertainty about their efficacy and safety. To compare the occurrence of secondary infections, digestive and hematological complication function of the administration of IL-6Ri we conducted a multicentric retrospective French observational study. All severe or critical COVID-19 requiring hospital admission were included. Among 2587 patients requiring hospital admission, 1603 had a severe COVID-19 and 984 a critical one requiring ICU admission. 224 received at least one dose of tocilizumab or sarilumab. Incidence of secondary infection was 29.5% in the IL-6Ri group <i>vs.</i> 19.5% without IL-6Ri (p = 0.0004) in the whole population. This result remained consistent after adjustment, without multiple imputation (MI) and after MI (adjusted OR: 1.47 [1.25; 1.72]; p &lt; 0.0001)). Incidence of hematological or digestive complication were similar between groups. Mortality of patients admitted in ward was higher in the IL-6Ri group (18.7% <i>vs</i> 10.5%, p = 0.0155). No difference in 28&#xa0;days, ICU, hospital of 90&#xa0;days mortality was noticed among ICU patients.</p><p><i>Clinical trial registration</i>: This study was registred on ClinicalTrial.gov: NCT05017441.</p>

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Benefit and risk associated with interleukin-6 receptor inhibitor administration during severe COVID-19: a retrospective multicentric study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月22日

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  • Charlène Lefèvre,
  • Théo Funck-Brentano,
  • Marine Cachanado,
  • Alexia Plocque,
  • Maëlle Youinou,
  • Audrey Fels,
  • Frédéric Pène,
  • Laurent Savale,
  • David Montani,
  • Olivier Voisin,
  • Flore Bintein,
  • Lucille Wildenberg,
  • Axel Philippe,
  • Stéphane Legriel,
  • Nicolas Roche,
  • Pierre-Régis Burgel,
  • Marc Tran,
  • Nicolas Noël,
  • Christophe Baillard,
  • Jacques Duranteau,
  • Gilles Chatellier,
  • Francois Philippart

摘要

During severe and critical COVID-19, therapeutic options remain scarce. Among interventions, the use of interleukin-6 receptor inhibitor (IL-6Ri) is especially controversial due to persistent uncertainty about their efficacy and safety. To compare the occurrence of secondary infections, digestive and hematological complication function of the administration of IL-6Ri we conducted a multicentric retrospective French observational study. All severe or critical COVID-19 requiring hospital admission were included. Among 2587 patients requiring hospital admission, 1603 had a severe COVID-19 and 984 a critical one requiring ICU admission. 224 received at least one dose of tocilizumab or sarilumab. Incidence of secondary infection was 29.5% in the IL-6Ri group vs. 19.5% without IL-6Ri (p = 0.0004) in the whole population. This result remained consistent after adjustment, without multiple imputation (MI) and after MI (adjusted OR: 1.47 [1.25; 1.72]; p < 0.0001)). Incidence of hematological or digestive complication were similar between groups. Mortality of patients admitted in ward was higher in the IL-6Ri group (18.7% vs 10.5%, p = 0.0155). No difference in 28 days, ICU, hospital of 90 days mortality was noticed among ICU patients.

Clinical trial registration: This study was registred on ClinicalTrial.gov: NCT05017441.