Addition of Tocilizumab to the Standard of Care Reduces Mortality in Severe COVID-19: A Systematic Review and Meta-Analysis

Frontiers in Medicine

article

Umesha Boregowda¹  Abhilash Perisetti²  Arpitha Nanjappa¹  Mahesh Gajendran³  Gurusaravanan Kutti Sridharan⁴  Hemant Goyal⁵ 

[1] Department of Internal Medicine, Bassett Medical Center, United States;Department of Gastroenterology and Hepatology, The University of Arkansas for Medical Sciences, United States;Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, United States;Department of Internal Medicine, University of Arizona, United States;The Wright Center for Graduate Medical Education, United States

关键词: tocilizumab (IL-6 inhibitor);    COVID-19;    coronavirus (2019-nCoV);    SARS-C0V-2 infection;    tocilizumab;    tocilizumab (TCZ);   

DOI  :  10.3389/fmed.2020.586221

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Tocilizumab (TCZ) is an anti-interleukin-6 antibody that has been used for the treatment of severe coronavirus disease 2019 (COVID-19). However, concrete evidence of its benefit in reducing mortality in severe COVID-19 is lacking. Therefore, we performed a systematic review and meta-analysis of relevant studies that compared the efficacy of TCZ in severe COVID-19 vs. standard of care (SOC) alone. Methods: A literature search for studies that compared “tocilizumab” and “standard of care” in the treatment of COVID-19 was done using major online databases from December 2019 to June 14, 2020. Search words “Tocilizumab,” “anti-interleukin-6 antibody,” and “COVID-19” or “coronavirus 2019” in various combinations were used. Articles in the form of abstracts, letters without original data, case reports, and reviews were excluded. Data were gathered on an Excel sheet, and statistical analysis was performed using Review Manager 5.3. Results: Sixteen studies were eligible from 693 initial studies, including 3,641 patients (64% males). There were 13 retrospective studies and three prospective studies. There were 2,488 patients in the SOC group (61.7%) and 1,153 patients (68.7%) in the TCZ group. The death rate in the TCZ group, 22.4% (258/1,153), was lower than in the SOC group, 26.21% (652/2,488) [pooled odds ratio 0.57 (95% CI 0.36–0.92), p = 0.02]. There was a significant heterogeneity (inconsistency index = 80%) among the included studies. Conclusion: The addition of TCZ to the SOC might reduce mortality in severe COVID-19. More extensive randomized clinical trials are needed to validate these findings.

【 授权许可】

CC BY