Evidence map›Paper›PMID 33200828›Full record

Observational studyJournal of medical virology2021

Tocilizumab in hospitalized patients with COVID-19: Clinical outcomes, inflammatory marker kinetics, and safety.

Joshua A Hill, Manoj P Menon, Shireesha Dhanireddy, Mark M Wurfel, Margaret Green, Rupali Jain, Jeannie D Chan, Joanne Huang, Danika Bethune, Cameron Turtle and 5 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of medical virology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 9 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

21 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
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  9. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2021
    Pooled it
  10. Review
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  18. Clinical presentation and outcomes of COVID-19 following hematopoietic cell transplantation and cellular therapy.Transplant infectious disease : an official journal of the Transplantation Society · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Joshua A HillDepartment of Medicine, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-7665-7100
Manoj P MenonDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Shireesha DhanireddyDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Mark M WurfelDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Margaret GreenDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Rupali JainDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Jeannie D ChanDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Joanne HuangDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Danika BethuneUniversity of Washington School of Medicine, Seattle, Washington, USA.
Cameron TurtleDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Christine JohnstonDepartment of Medicine, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-3073-0843
Hu XieClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Wendy M LeisenringClinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
H Nina KimDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Guang-Shing ChengDepartment of Medicine, University of Washington, Seattle, Washington, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Coronavirus disease 2019 (COVID-19) due to infection with severe acute respiratory syndrome coronavirus 2 causes substantial morbidity. Tocilizumab, an interleukin-6 receptor antagonist, might improve outcomes by mitigating inflammation. We conducted a retrospective study of patients admitted to the University of Washington Hospital system with COVID-19 and requiring supplemental oxygen. Outcomes included clinical improvement, defined as a two-point reduction in severity on a six-point ordinal scale or discharge, and mortality within 28 days. We used Cox proportional-hazards models with propensity score inverse probability weighting to compare outcomes in patients who did and did not receive tocilizumab. We evaluated 43 patients who received tocilizumab and 45 who did not. Patients receiving tocilizumab were younger with fewer comorbidities but higher baseline oxygen requirements. Tocilizumab treatment was associated with reduced C-reactive protein, fibrinogen, and temperature, but there were no meaningful differences in time to clinical improvement (adjusted hazard ratio [aHR], 0.92; 95% confidence interval [CI], 0.38-2.22) or mortality (aHR, 0.57; 95% CI, 0.21-1.52). A numerically higher proportion of tocilizumab-treated patients had subsequent infections, transaminitis, and cytopenias. Tocilizumab did not improve outcomes in hospitalized patients with COVID-19. However, this study was not powered to detect small differences, and there remains the possibility for a survival benefit.

Indexed as

COVID-19 Drug TreatmentAgedAntibodies, Monoclonal, HumanizedCOVID-19C-Reactive ProteinFemaleFibrinogenHospitalizationHumansImmunomodulationInflammationInflammation MediatorsMaleMiddle AgedReceptors, Interleukin-6Retrospective StudiesAntibodies, Monoclonal, HumanizedC-Reactive ProteinFibrinogenInflammation MediatorsReceptors, Interleukin-6tocilizumabcoronavirusCOVID-19immunomodulatorySARS-CoV-2tocilizumab

Identifiers

PMID33200828
PMCPMC7753799

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.