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. 2022 Mar 24;8(4):339. doi: 10.3390/jof8040339

Table 2.

Tocilizumab administration, diagnostic time, treatment of invasive aspergillosis, and outcomes.

Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Patient 6
First tocilizumab dose 5.2 mg/kg 11 mg/kg 4 mg/kg 7.5 mg/kg 6.25 mg/kg 6 mg/kg
Second tocilizumab dose 5.2 mg/kg n/a 4 mg/kg 7.5 mg/kg 3.1 mg/kg 6 mg/kg
Days between 1ST and 2nd tocilizumab dose 3 n/a 4 6 8 11
Total cumulative tocilizumab dose 10.4 mg/kg 11 mg/kg 8 mg/kg 15 mg/kg 9.38 mg/kg 12.12 mg/kg
Status of capa $ Probable Probable Probable Probable Probable Probable
Usage of penicillin before diagnosis No No Yes,
piperacillin/tazobactam
Yes,
piperacillin/tazobactam
No No
Blood Aspergillus AG titer while IA diagnosed 0.69 0.61 0.73 1.82 0.76 1.09
The highest blood ASPERGILLUS AG titer 1.60 6.62 1.14 3.17 2.26 4.71
The highest BAL ASPERGILLUS AG titer 7.09 0.89 0.36 0.76 0.26 0.41
Imagine evidence of aspergillosis in chest CT N/A Nonspecific findings N/A Clusters of fluffy nodules Diffuse ground glass opacity with reticulations Diffuse ground glass opacity with consolidations
Days after COVID-19 symptom onset to IA diagnosed 32 32 15 21 20 27
Days after ICU admission to IA diagnosed 28 19 6 18 11 10
Days after 1ST tocilizumab dose to IA diagnosed 28 26 9 13 11 21
Days after 2nd tocilizumab dose to IA diagnosed 25 n/a 5 7 3 10
Antifungal agent Voriconazole Voriconazole + caspofungin,
switched to posaconazole
Voriconazole Voriconazole, add-on caspofungin Voriconazole + micafungin, switched to posaconazole Voriconazole, add-on caspofungin
Outcomes Death on Day 51 Death on Day 168 Discharged on Day 28 Discharged on Day 76 Discharged on Day 61 Discharged on Day 151 (respiratory care ward)

Note: n/a: not applicable; IA: invasive aspergillosis; Ag: antigen; ICU: Intensive Care Unit; CAPA: COVID-19-associated pulmonary aspergillosis; BAL: bronchoalveolar lavage; CT: computed tomography. $: according to Koehler 2020, Lancet Infect Dis [7].