在严重的COVID-19期间使用介素-6受体抑制剂的益处和风险:一项回顾性多中心研究
Charlène Lefèvre1, Théo Funck-Brentano1, Marine Cachanado2
1Medical and Surgical Intensive Care Department, Paris Saint Joseph Hospital, Paris, France.
Scientific reports
|January 22, 2026
概括
像托西利祖马布 (tocilizumab) 这样的干白素-6受体抑制剂 (IL-6Ri) 可能会增加严重的COVID-19患者的二次感染. 然而,IL-6Ri没有影响血液或消化系统并发症,根据患者的位置,死亡率的结果各不相同.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 对于严重和危急的COVID-19的治疗选择有限.
- 干白素-6受体抑制剂 (IL-6Ri) 在COVID-19治疗中的有效性和安全性仍然存在争议.
- 关于IL-6Ri对二次感染和并发症的影响存在不确定性.
研究的目的:
- 为了比较二次感染,消化系统和血液学并发症的发病率,在接受IL-6Ri治疗的严重或危急的COVID-19患者与未接受IL-6Ri治疗的患者之间.
- 评估IL-6Ri对住院COVID-19患者死亡率的影响.
主要方法:
- 一个多中心的回顾性法国观察研究.
- 包括所有需要住院治疗的严重或危急的COVID-19患者.
- 接受托西利祖马布或沙利祖马布 (IL-6Ri组) 和未接受托西利祖马布或沙利祖马布 (IL-6Ri组) 的患者之间的结局比较.
主要成果:
- 二次感染的发生率在IL-6Ri组 (29.5%) 与非IL-6Ri组 (19.5%) 相比显著更高 (p < 0.0004).
- 血液或消化系统并发症在两组之间发生率相似.
- 在病房住院的患者中,IL-6Ri组的死亡率较高 (18.7%与10.5%,p = 0.0155),但在28或90天的ICU患者中没有显著差异.
结论:
- IL-6受体抑制剂 (IL-6Ri) 与严重的COVID-19患者中二次感染的风险增加有关.
- 虽然IL-6Ri没有影响血液或消化系统并发症,但它们与非ICU患者的死亡率更高有关.
- 需要进一步的研究来澄清IL-6Ri在治疗严重COVID-19中的风险益处概况.
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