Evidence map›Paper›PMID 32482597›Full record

ArticleEuropean journal of internal medicine2020

Efficacy and safety of tocilizumab in severe COVID-19 patients: a single-centre retrospective cohort study.

Corrado Campochiaro, Emanuel Della-Torre, Giulio Cavalli, Giacomo De Luca, Marco Ripa, Nicola Boffini, Alessandro Tomelleri, Elena Baldissera, Patrizia Rovere-Querini, Annalisa Ruggeri and 7 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
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 249 papers, 23 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
249citing papers in PubMed, 23 pooled it
10.0field-weighted citation impact, top 2% of its field
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

249 citing papers in PubMed, 23 syntheses or guidelines pooled it, 413 citations in OpenAlex.

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189 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 3 institutions in 1 country.

Corrado CampochiaroVita-Salute San Raffaele University, Milan, Italy; Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: campochiaro.corrado@hsr.it.
Emanuel Della-TorreVita-Salute San Raffaele University, Milan, Italy; Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy.
Giulio CavalliVita-Salute San Raffaele University, Milan, Italy; Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy.
Giacomo De LucaVita-Salute San Raffaele University, Milan, Italy; Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy.
Marco RipaVita-Salute San Raffaele University, Milan, Italy; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Nicola BoffiniUnit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy.
Alessandro TomelleriVita-Salute San Raffaele University, Milan, Italy; Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy.
Elena BaldisseraUnit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy.
Patrizia Rovere-QueriniVita-Salute San Raffaele University, Milan, Italy; Internal Medicine, Diabetes & Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Annalisa RuggeriHematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Giacomo MontiAnesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Francesco De CobelliVita-Salute San Raffaele University, Milan, Italy; Radiology Department, IRCSS San Raffaele Scientific Institute, Milan, Italy.
Alberto ZangrilloVita-Salute San Raffaele University, Milan, Italy; Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Moreno TresoldiGeneral Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Antonella CastagnaVita-Salute San Raffaele University, Milan, Italy; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Lorenzo DagnaVita-Salute San Raffaele University, Milan, Italy; Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: lorenzo.dagna@unisr.it.
TOCI-RAF Study Group
Istituti di Ricovero e Cura a Carattere Scientifico · ITIstituto di Ricovero e Cura a Carattere Scientifico San RaffaeleVita-Salute San Raffaele University · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTocilizumab (TCZ), a humanized monoclonal antibody targeting the interleukin-6 (IL-6) receptor, has been proposed for the treatment of COVID-19 patients; however, limited data are available on the safety and efficacy.

methodsWe performed a retrospective study on severe COVID-19 patients with hyper-inflammatory features admitted outside intensive care units (ICUs). Patients treated with intravenous TCZ in addition to standard of care were compared to patients treated with standard of care alone. Safety and efficacy were assessed over a 28-day follow-up.

results65 patients were included. Among them, 32 were treated with TCZ. At baseline, all patients were on high-flow supplemental oxygen and most (78% of TCZ patients and 61% of standard treatment patients) were on non-invasive ventilation. During the 28-day follow-up, 69% of TCZ patients experienced a clinical improvement compared to 61% of standard treatment patients (p = 0.61). Mortality was 15% in the tocilizumab group and 33% in standard treatment group (p = 0.15). In TCZ group, at multivariate analysis, older age was a predictor of death, whereas higher baseline PaO2:FiO2 was a predictor of clinical improvement at day 28. The rate of infection and pulmonary thrombosis was similar between the two groups.

conclusionsAt day 28, clinical improvement and mortality were not statistically different between tocilizumab and standard treatment patients in our cohort. Bacterial or fungal infections were recorded in 13% of tocilizumab patients and in 12% of standard treatment patients. Confirmation of efficacy and safety will require ongoing controlled trials.

Indexed as

Antibodies, Monoclonal, HumanizedCoronavirus InfectionsOxygen Inhalation TherapyPandemicsPneumonia, ViralRespiratory InsufficiencyAgedAntiviral AgentsBetacoronavirusCOVID-19FemaleHumansItalyMaleMiddle AgedOutcome and Process Assessment, Health CareAntibodies, Monoclonal, HumanizedAntiviral AgentsReceptors, Interleukin-6tocilizumabCoronavirusCOVID-19EfficacyInterleukin-6ItalySafetyTocilizumab

Identifiers

PMID32482597
PMCPMC7242960
OpenAlexW3026301261

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.