COVID-19: Tocilizumab / Risk in Young Adults / TB, Malaria, HIV Risk

By Kelly Young

NEJM Journal Watch

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Have a look at some of the latest research news on COVID-19:

Tocilizumab: Among patients with COVID-19 who required mechanical ventilation, receipt of tocilizumab was associated with a 45% lower mortality risk relative to not receiving it, according to an observational study in Clinical Infectious Diseases. Researchers studied roughly 150 patients. Roughly half received tocilizumab, an interleukin-6 receptor antagonist. During a median follow-up of 47 days, tocilizumab was associated with a higher rate of superinfections (54% vs. 26%), mostly driven by ventilator-associated pneumonia; however, tocilizumab patients who had a superinfection didn’t have higher mortality rates than those without a superinfection. Tocilizumab recipients had lower 28-day mortality rates than other patients (18% vs. 36%).

COVID-19 risk in young adults: Roughly 1 in 3 young adults are at risk for severe COVID-19, according to a study in the Journal of Adolescent Health. Using National Health Interview Survey data, researchers calculated the proportion of U.S. adults aged 18 to 25 who had conditions that put them at greater risk for severe COVID-19, including heart conditions, diabetes, asthma, immune conditions, liver conditions, and obesity. People who used tobacco, electronic cigarettes, and cigars in the past 30 days were also at risk. Overall, 32% were medically vulnerable. Smoking and e-cigarette use were among the most common medical vulnerabilities, affecting 11% and 7%, respectively. When only considering nonsmokers, the medical vulnerability rate was only 16%. White adults had higher rates of medical vulnerability than other races and ethnicities, but the authors note that other studies have found greater COVID-19 morbidity and mortality in racial and ethnic minorities.

TB, malaria, and HIV: A modeling study in The Lancet Global Health estimates that in high-burden countries, mortality from malaria could be expected to increase by 36% over 5 years, compared with a period without the COVID-19 pandemic. For tuberculosis and HIV, mortality figures could increase 20% and 10%, respectively. The increases are expected because of delayed diagnosis and treatment and reduced access to care and mosquito nets.