Observational studyBMC infectious diseases2021
Tocilizumab improves survival in severe COVID-19 pneumonia with persistent hypoxia: a retrospective cohort study with follow-up from Mumbai, India.
Observational study in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 5 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 5 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Effects of Tocilizumab on Adults With COVID-19 Pneumonia: A Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Tocilizumab administration for the treatment of hospitalized patients with COVID-19: A systematic review and meta-analysis.Respirology (Carlton, Vic.) · 2021Pooled it
- Beneficial and harmful outcomes of tocilizumab in severe COVID-19: A systematic review and meta-analysis.Pharmacotherapy · 2021Pooled it
- Tocilizumab treatment for COVID-19 patients: a systematic review and meta-analysis.Infectious diseases of poverty · 2021Pooled it
- 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 · 2021Pooled it
- Article
- Mechanisms and clinical research progress of IL-6-mediated crosstalk between the alveolar microenvironment and the immune system in patients with severe pneumonia undergoing mechanical ventilation.Frontiers in immunology · 2026Review
- Muscle matters: Transforming the care of intensive care unit acquired sarcopenia and myosteatosis.World journal of clinical cases · 2025Review
- Correlation of METTL4 genetic variants and severe pneumonia pediatric patients in Southern China.BMC genomic data · 2025Article
- In-hospital mortality predictors among COVID-19 patients in the West Bank, Palestine: a multi-center retrospective cohort study.Frontiers in medicine · 2025Article
- Cytokine storm and translating IL-6 biology into effective treatments for COVID-19.Frontiers of medicine · 2023Review
- Comparison of COVID-19 Preprint and Peer-Reviewed Versions of Studies on Therapies for Critically Ill Patients.Journal of intensive care medicine · 2023Article
- A phosphodiesterase-4 inhibitor reduces lung inflammation and fibrosis in a hamster model of SARS-CoV-2 infection.Frontiers in immunology · 2023Article
- Molecular targets for cystic fibrosis and therapeutic potential of monoclonal antibodies.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2022Review
- Investigation of the relationship of CO-RADS and CT patterns with laboratory parameters in COVID-19 patients and a new perspective on the total CT scoring system.BMC medical imaging · 2022Article
- A novel definition and treatment of hyperinflammation in COVID-19 based on purinergic signalling.Purinergic signalling · 2022Review
- Pharmacokinetic/Pharmacodynamic Considerations of Alternate Dosing Strategies of Tocilizumab in COVID-19.Clinical pharmacokinetics · 2022Review
- Single versus multiple doses of Tocilizumab in critically ill patients with coronavirus disease 2019 (COVID-19): A two-center, retrospective cohort study.Journal of critical care · 2021Article
- Efficacy of tocilizumab in treatment of COVID-19 pneumonia: A case-control study from a tertiary care hospital.Lung India : official organ of Indian Chest SocietyArticle
- "Efficacy of tocilizumab in treatment of COVID-19 pneumonia: A case-control study from a tertiary care hospital".Lung India : official organ of Indian Chest SocietyArticle
Corrections and comments
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Authors and funding
30 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCytokine storm triggered by Severe Coronavirus Disease 2019 (COVID-19) is associated with high mortality. With high Interleukin -6 (IL-6) levels reported in COVID-19 related deaths in China, IL-6 is considered to be the key player in COVID-19 cytokine storm. Tocilizumab, a monoclonal antibody against IL-6 receptor, is used on compassionate grounds for treatment of COVID-19 cytokine storm. The aim of this study was to assess effect of tocilizumab on mortality due to COVID-19 cytokine storm.
methodThis retrospective, observational study included patients of severe COVID-19 pneumonia with persistent hypoxia (defined as saturation 94% or less on supplemental Oxygen of 15 L per minute through non-rebreathing mask or PaO2/FiO2 ratio of less than 200) who were admitted to a tertiary care center in Mumbai, India, between 31st March to 5th July 2020. In addition to standard care, single Inj. Tocilizumab 400 mg was given intravenously to 151 consecutive COVID-19 patients with persistent hypoxia, from 13th May to 5th July 2020. These 151 patients were retrospectively analysed and compared with historic controls, ie consecutive COVID-19 patients with persistent hypoxia, defined as stated above (N = 118, from our first COVID-19 admission on 31st March to 12th May 2020 i.e., till tocilizumab was available in hospital). Univariate and multivariate Cox regression analysis was performed for identifying predictors of survival. Statistical analysis was performed using IBM SPSS version 26.
resultsOut of 269 (151 in tocilizumab group and 118 historic controls) patients studied from 31st March to 5th July 2020, median survival in the tocilizumab group was significantly longer than in the control group; 18 days (95% CI, 11.3 to 24.7) versus 9 days (95% CI, 5.7 to 12.3); log rank p 0.007. On multivariate Cox regression analysis, independent predictors of survival were use of tocilizumab (HR 0.621, 95% CI 0.427-0.903, P 0.013) and higher oxygen saturation.
conclusionTocilizumab may improve survival in severe COVID-19 pneumonia with persistent hypoxia. Randomised controlled trials on use of tocilizumab as rescue therapy in patients of severe COVID-19 pneumonia with hypoxia (PaO2/FiO2 less than 200) due to hyperinflammatory state, are warranted.
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