tetano
Editor, Senior Moderator
World J Methodol
. 2021 May 20;11(3):95-109.
doi: 10.5662/wjm.v11.i3.95.
Tocilizumab as treatment for COVID-19: A systematic review and meta-analysis
Fausto Petrelli[SUP] 1 [/SUP], Sara Cherri[SUP] 2 [/SUP], Michele Ghidini[SUP] 3 [/SUP], Gianluca Perego[SUP] 4 [/SUP], Antonio Ghidini[SUP] 5 [/SUP], Alberto Zaniboni[SUP] 6 [/SUP]
Affiliations
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 9[SUP]th[/SUP] 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.
Keywords: COVID-19; Meta-analysis; Pandemic; Review; Tocilizumab; Treatment.
. 2021 May 20;11(3):95-109.
doi: 10.5662/wjm.v11.i3.95.
Tocilizumab as treatment for COVID-19: A systematic review and meta-analysis
Fausto Petrelli[SUP] 1 [/SUP], Sara Cherri[SUP] 2 [/SUP], Michele Ghidini[SUP] 3 [/SUP], Gianluca Perego[SUP] 4 [/SUP], Antonio Ghidini[SUP] 5 [/SUP], Alberto Zaniboni[SUP] 6 [/SUP]
Affiliations
- PMID: 34026583
- PMCID: PMC8127418
- DOI: 10.5662/wjm.v11.i3.95
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 9[SUP]th[/SUP] 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.
Keywords: COVID-19; Meta-analysis; Pandemic; Review; Tocilizumab; Treatment.