Evidence map›Paper›PMID 32405160›Full record

ArticleEuropean journal of internal medicine2020

Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia.

Ruggero Capra, Nicola De Rossi, Flavia Mattioli, Giuseppe Romanelli, Cristina Scarpazza, Maria Pia Sormani, Stefania Cossi

Abstract read
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In one paragraph

Article in European journal of internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 157 papers, 25 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
157citing papers in PubMed, 25 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

157 citing papers in PubMed, 25 syntheses or guidelines pooled it.

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  9. Immunomodulation as Treatment for Severe Coronavirus Disease 2019: A Systematic Review of Current Modalities and Future Directions.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021
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  18. Is there any potential management against COVID-19? A systematic review and meta-analysis.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2020
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97 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Ruggero CapraCovid 19 Unit, Montichiari Hospital via Don Ciotti Montichiari (Brescia) Italy. Electronic address: ruggero.capra@gmail.com.
Nicola De RossiCovid 19 Unit, Montichiari Hospital via Don Ciotti Montichiari (Brescia) Italy.
Flavia MattioliASST Spedali Civili, Via Nikolajewka 13 25123 Brescia Italy.
Giuseppe RomanelliUniversity of Brescia, Department of Internal Medicine, Italy.
Cristina ScarpazzaDepartment of General Psychology, University of Padova, Italy.
Maria Pia SormaniDepartment of Health Sciences, University of Genova, Italy, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Stefania CossiCovid 19 Unit, Montichiari Hospital via Don Ciotti Montichiari (Brescia) Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPneumonia with respiratory failure represents the main cause of death in COVID-19, where hyper inflammation plays an important role in lung damage. This study aims to evaluate if tocilizumab, an anti-soluble IL-6 receptor monoclonal antibody, reduces patients' mortality.

methods85 consecutive patients admitted to the Montichiari Hospital (Italy) with COVID-19 related pneumonia and respiratory failure, not needing mechanical ventilation, were included if satisfying at least one among: respiratory rate ≥ 30 breaths/min, peripheral capillary oxygen saturation ≤ 93% or PaO2/FiO2<=300 mmHg. Patients admitted before March 13th (n=23) were prescribed the standard therapy (hydroxychloroquine, lopinavir and ritonavir) and were considered controls. On March 13th tocilizumab was available and patients admitted thereafter (n=62) received tocilizumab once within 4 days from admission, plus the standard care.

resultsPatients receiving tocilizumab showed significantly greater survival rate as compared to control patients (hazard ratio for death, 0.035; 95% confidence interval [CI], 0.004 to 0.347; p = 0.004), adjusting for baseline clinical characteristics. Two out of 62 patients of the tocilizumab group and 11 out of 23 in the control group died. 92% and 42.1% of the discharged patients in the tocilizumab and control group respectively, recovered. The respiratory function resulted improved in 64.8% of the observations in tocilizumab patients who were still hospitalized, whereas 100% of controls worsened and needed mechanical ventilation. No infections were reported.

conclusionsTocilizumab results to have a positive impact if used early during Covid-19 pneumonia with severe respiratory syndrome in terms of increased survival and favorable clinical course.

Indexed as

Antibodies, Monoclonal, HumanizedCoronavirus InfectionsPandemicsPneumonia, ViralRespiratory InsufficiencyAgedAntiviral AgentsBetacoronavirusCOVID-19Dose-Response Relationship, DrugEarly Medical InterventionFemaleHumansItalyMaleMiddle AgedAntibodies, Monoclonal, HumanizedAntiviral AgentsReceptors, Interleukin-6tocilizumabCOVID-19PneumoniaRespiratory failureRetrospective studySARS-cov-2Tocilizumab

Identifiers

PMID32405160
PMCPMC7219361

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.