Evidence map›Paper›PMID 33332779›Full record

Trial reportThe New England journal of medicine2021

Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia.

Carlos Salama, Jian Han, Linda Yau, William G Reiss, Benjamin Kramer, Jeffrey D Neidhart, Gerard J Criner, Emma Kaplan-Lewis, Rachel Baden, Lavannya Pandit and 10 more

4 registry-linked trialsOpen access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 765 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
765citing papers in PubMed, 8 pooled it
29.6field-weighted citation impact, top 1% 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.

NCT04372186 phase3completednot on this map

A Randomized, Double-Blind, Placebo-Controlled, Multicenter Study to Evaluate the Efficacy and Safety of Tocilizumab in Hospitalized Patients With COVID-19 Pneumonia

TypeinterventionalSponsorGenentech, Inc.Ran2020 to 2020Enrolled377ConditionsCOVID-19 PneumoniaArmsPlacebo, Tocilizumab
NCT04924829 unknown statusnot on this map

Safety and Effectiveness Observational Study of Anti IL-6 Tocilizumab in Hospital Admitted Patients With Severe COVID-19 Pneumonia.

TypeobservationalSponsorHospital Italiano de Buenos AiresRan2021 to 2021Enrolled300ConditionsSevere COVID 19 Pneumonia, TocilizumabArmsTocilizumab
NCT04930874 naterminatednot on this map

Cerebral Autoregulation and Severe Coronavirus Disease 19 [CA-COVID]: a Single-center Physiological Study

TypeinterventionalSponsorUniversity of AthensRan2021 to 2022Enrolled7ConditionsCOVID-19 Acute Respiratory Distress Syndrome, COVID-19 PneumoniaArmsNIRS (Near-Infrared Spectroscopy)
NCT05226754 phase2unknown statusnot on this mapstarted 2022, after this paper: background citation

Study Design of the Diacerein Effect on Inflammatory Response in Patients With Covid-19: a Randomized, Placebo-controlled, Double-blind Trial.

TypeinterventionalSponsorUniversity of Campinas, BrazilRan2022 to 2023Enrolled40ConditionsCOVID-19ArmsDiacerein, placebo capsules
3 · Its place in the literature

Who cites it

765 citing papers in PubMed, 8 syntheses or guidelines pooled it, 1,319 citations in OpenAlex.

  1. Pooled it
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  3. Guideline
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  5. Psychotropic drug repurposing for COVID-19: A Systematic Review and Meta-Analysis.European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2023
    Pooled it
  6. Pooled it
  7. Effect of tocilizumab, sarilumab, and baricitinib on mortality among patients hospitalized for COVID-19 treated with corticosteroids: a systematic review and meta-analysis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2023
    Pooled it
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705 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 1 institution in 1 country.

Carlos SalamaFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Jian HanFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Linda YauFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
William G ReissFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Benjamin KramerFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Jeffrey D NeidhartFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Gerard J CrinerFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Emma Kaplan-LewisFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Rachel BadenFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Lavannya PanditFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Miriam L CameronFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Julia Garcia-DiazFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Victoria ChávezFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Martha Mekebeb-ReuterFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Ferdinando Lima de MenezesFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Reena ShahFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Maria F González-LaraFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Beverly AssmanFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Jamie FreedmanFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Shalini V MohanFrom Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai Hospital (C.S.), and Elmhurst Hospital Center-New York City Health and Hospitals (E.K.-L.) - both in New York; Genentech, South San Francisco (J.H., L.Y., W.G.R., B.K., B.A., J.F., S.V.M.), and Highland Hospital, Oakland (R.B.) - both in California; San Juan Oncology Associates, Farmington, NM (J.D.N); Lewis Katz School of Medicine at Temple University, Philadelphia (G.J.C.); Michael E. DeBakey Houston VA Medical Center, Houston (L.P.); Holy Cross Health, Silver Spring, MD (M.L.C.); Ochsner Clinic Foundation, New Orleans (J.G.-D.); Central Military Hospital, Lima, Peru (V.C.); Stellenbosch University, Cape Town, South Africa (M.M.-R); BR Trials-Clinical Research, São Paulo (F.L.M.); Aga Khan University Hospital, Nairobi (R.S.); and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City (M.F.G.-L.).
Elmhurst Hospital Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCoronavirus disease 2019 (Covid-19) pneumonia is often associated with hyperinflammation. Despite the disproportionate incidence of Covid-19 among underserved and racial and ethnic minority populations, the safety and efficacy of the anti-interleukin-6 receptor antibody tocilizumab in patients from these populations who are hospitalized with Covid-19 pneumonia are unclear.

methodsWe randomly assigned (in a 2:1 ratio) patients hospitalized with Covid-19 pneumonia who were not receiving mechanical ventilation to receive standard care plus one or two doses of either tocilizumab (8 mg per kilogram of body weight intravenously) or placebo. Site selection was focused on the inclusion of sites enrolling high-risk and minority populations. The primary outcome was mechanical ventilation or death by day 28.

resultsA total of 389 patients underwent randomization, and the modified intention-to-treat population included 249 patients in the tocilizumab group and 128 patients in the placebo group; 56.0% were Hispanic or Latino, 14.9% were Black, 12.7% were American Indian or Alaska Native, 12.7% were non-Hispanic White, and 3.7% were of other or unknown race or ethnic group. The cumulative percentage of patients who had received mechanical ventilation or who had died by day 28 was 12.0% (95% confidence interval [CI], 8.5 to 16.9) in the tocilizumab group and 19.3% (95% CI, 13.3 to 27.4) in the placebo group (hazard ratio for mechanical ventilation or death, 0.56; 95% CI, 0.33 to 0.97; P = 0.04 by the log-rank test). Clinical failure as assessed in a time-to-event analysis favored tocilizumab over placebo (hazard ratio, 0.55; 95% CI, 0.33 to 0.93). Death from any cause by day 28 occurred in 10.4% of the patients in the tocilizumab group and 8.6% of those in the placebo group (weighted difference, 2.0 percentage points; 95% CI, -5.2 to 7.8). In the safety population, serious adverse events occurred in 38 of 250 patients (15.2%) in the tocilizumab group and 25 of 127 patients (19.7%) in the placebo group.

conclusionsIn hospitalized patients with Covid-19 pneumonia who were not receiving mechanical ventilation, tocilizumab reduced the likelihood of progression to the composite outcome of mechanical ventilation or death, but it did not improve survival. No new safety signals were identified. (Funded by Genentech; EMPACTA ClinicalTrials.gov number, NCT04372186.).

Indexed as

COVID-19 Drug TreatmentAdultAgedAntibodies, Monoclonal, HumanizedCOVID-19Disease ProgressionFemaleHospitalizationHumansIntention to Treat AnalysisMaleMiddle AgedPneumonia, ViralRespiration, ArtificialSurvival RateAntibodies, Monoclonal, Humanizedtocilizumab

Identifiers

PMID33332779
PMCPMC7781101
OpenAlexW3110844195

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