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Tocilizumab as treatment for COVID-19: A systematic review and meta-analysis.
World J Methodol. 2021 May 20; 11(3):95-109.WJ

Abstract

BACKGROUND

The majority of patients with coronavirus disease 2019 (COVID-19) have good prognoses, but some develop a critical illness that can lead to death. Evidence shows severe acute respiratory syndrome is closely related to the induced cytokine storm. Interleukin-6 is a key player; its role in systemic inflammation is well known.

AIM

To evaluate the effect of tocilizumab (TCZ), an interleukin-6 receptor antagonist, on the outcomes for patients with COVID-19 pneumonia.

METHODS

PubMed, EMBASE, SCOPUS, Web of Science, MedRxiv, Science Direct, and the Cochrane Library were searched from inception to 9th June 2020 for observational or prospective studies reporting results of hospitalized adult patients with COVID-19 infection treated with TCZ. Effect sizes were reported as odds ratios (ORs) with 95% confidence intervals (CIs), and an OR less than 1 was associated with a better outcome in those treated with TCZ.

RESULTS

Overall 13476 patients (33 studies; n = 3264 received TCZ) with COVID-19 pneumonia and various degree of severity were included. Outcome was improved with TCZ. In the primary analysis (n = 19 studies reporting data), mortality was reduced in patients treated with TCZ (OR = 0.64, 95%CI: 0.47-0.87; P < 0.01). In 9 studies where risk of death with TCZ use was controlled for other variables mortality was reduced by 57% (OR = 0.43, 95%CI: 0.27-0.7; P < 0.01). Intensive care need (mechanical ventilation) was also reduced (OR = 0.36, 95%CI: 0.14-0.89; P = 0.02).

CONCLUSION

In COVID-19-infected patients treated with TCZ, outcome may be improved compared to those not treated with TCZ.

Authors+Show Affiliations

Oncology Unit, Asst Bergamo Ovest, Milano 20124, Italy. faustopetrelli@gmail.com.Department of Clinical Oncology, Fondazione Poliambulanza, Brescia 25124, Italy.Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Pharmacy Unit, San Raffaele Hospital, Milano 20100, Italy.Department of Medicine, Casa di Cura Igea, Milano 20100, Italy.Department of Oncology, Fondazione Poliambulanza, Brescia 25124, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34026583

Citation

Petrelli, Fausto, et al. "Tocilizumab as Treatment for COVID-19: a Systematic Review and Meta-analysis." World Journal of Methodology, vol. 11, no. 3, 2021, pp. 95-109.
Petrelli F, Cherri S, Ghidini M, et al. Tocilizumab as treatment for COVID-19: A systematic review and meta-analysis. World J Methodol. 2021;11(3):95-109.
Petrelli, F., Cherri, S., Ghidini, M., Perego, G., Ghidini, A., & Zaniboni, A. (2021). Tocilizumab as treatment for COVID-19: A systematic review and meta-analysis. World Journal of Methodology, 11(3), 95-109. https://doi.org/10.5662/wjm.v11.i3.95
Petrelli F, et al. Tocilizumab as Treatment for COVID-19: a Systematic Review and Meta-analysis. World J Methodol. 2021 May 20;11(3):95-109. PubMed PMID: 34026583.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tocilizumab as treatment for COVID-19: A systematic review and meta-analysis. AU - Petrelli,Fausto, AU - Cherri,Sara, AU - Ghidini,Michele, AU - Perego,Gianluca, AU - Ghidini,Antonio, AU - Zaniboni,Alberto, Y1 - 2021/05/20/ PY - 2020/11/01/received PY - 2020/12/02/revised PY - 2021/03/28/accepted PY - 2021/5/24/entrez PY - 2021/5/25/pubmed PY - 2021/5/25/medline KW - COVID-19 KW - Meta-analysis KW - Pandemic KW - Review KW - Tocilizumab KW - Treatment SP - 95 EP - 109 JF - World journal of methodology JO - World J Methodol VL - 11 IS - 3 N2 - BACKGROUND: The majority of patients with coronavirus disease 2019 (COVID-19) have good prognoses, but some develop a critical illness that can lead to death. Evidence shows severe acute respiratory syndrome is closely related to the induced cytokine storm. Interleukin-6 is a key player; its role in systemic inflammation is well known. AIM: To evaluate the effect of tocilizumab (TCZ), an interleukin-6 receptor antagonist, on the outcomes for patients with COVID-19 pneumonia. METHODS: PubMed, EMBASE, SCOPUS, Web of Science, MedRxiv, Science Direct, and the Cochrane Library were searched from inception to 9th June 2020 for observational or prospective studies reporting results of hospitalized adult patients with COVID-19 infection treated with TCZ. Effect sizes were reported as odds ratios (ORs) with 95% confidence intervals (CIs), and an OR less than 1 was associated with a better outcome in those treated with TCZ. RESULTS: Overall 13476 patients (33 studies; n = 3264 received TCZ) with COVID-19 pneumonia and various degree of severity were included. Outcome was improved with TCZ. In the primary analysis (n = 19 studies reporting data), mortality was reduced in patients treated with TCZ (OR = 0.64, 95%CI: 0.47-0.87; P < 0.01). In 9 studies where risk of death with TCZ use was controlled for other variables mortality was reduced by 57% (OR = 0.43, 95%CI: 0.27-0.7; P < 0.01). Intensive care need (mechanical ventilation) was also reduced (OR = 0.36, 95%CI: 0.14-0.89; P = 0.02). CONCLUSION: In COVID-19-infected patients treated with TCZ, outcome may be improved compared to those not treated with TCZ. SN - 2222-0682 UR - https://www.unboundmedicine.com/medline/citation/34026583/Tocilizumab_as_treatment_for_COVID_19:_A_systematic_review_and_meta_analysis_ L2 - https://www.wjgnet.com/2222-0682/full/v11/i3/95.htm DB - PRIME DP - Unbound Medicine ER -
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