Evidence map›Paper›PMID 33915284›Full record

SynthesisClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2021

Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis, first update.

Imad M Tleyjeh, Zakariya Kashour, Muhammad Riaz, Leslie Hassett, Viviane C Veiga, Tarek Kashour

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 5 pooled it
3.5field-weighted citation impact, top 6% 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

23 citing papers in PubMed, 5 syntheses or guidelines pooled it, 62 citations in OpenAlex.

  1. Pooled it
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  6. Observational
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  8. Article
  9. Consequences of COVID-19 on Adipose Tissue Signatures.International journal of molecular sciences · 2024
    Article
  10. Article
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  16. Review
  17. Analysis of the factors predicting clinical response to tocilizumab therapy in patients with severe COVID-19.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022
    Article
  18. Treatment with Tocilizumab in Adult Patients with Moderate to Critical COVID-19 Pneumonia: A Single-Center Retrospective Study.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022
    Article
  19. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 5 countries.

Imad M TleyjehInfectious Diseases Section, Department of Medical Specialties King Fahad Medical City, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Division of Epidemiology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA. Electronic address: Tleyjeh.Imad@mayo.edu.
Zakariya KashourDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Muhammad RiazDepartment of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
Leslie HassettMayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA.
Viviane C VeigaBP-A Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, São Paulo, Brazil; Brazilian Research in Intensive Care Network-BRICNet, São Paulo, SP, Brazil.
Tarek KashourDepartment of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia.
Mayo Clinic · USBrazilian Research in Intensive Care Network · BRKing Saud Medical City · SAQatar University · QAUniversity of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesCytokine release syndrome with elevated interleukin-6 (IL-6) levels is associated with multiorgan damage and death in severe coronavirus disease 2019 (COVID-19). Our objective was to update the data in a living systematic review of the literature concerning the efficacy and toxicity of the IL-6 receptor antagonist tocilizumab in COVID-19 patients.

methodsData sources were Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Web of Science, Scopus up, preprint servers and Google from 8th October 2020 till 24th February 2021. Eligible studies were randomized controlled trials (RCTs) and observational studies at low or moderate risk of bias. The participants were hospitalized COVID-19 patients, and intervention was tocilizumab versus placebo or standard of care. We pooled crude risk ratios (RRs) of RCTs with a random effects model and evaluated inconsistency between studies with I

resultsOf 1600 citations, eight RCTs and 28 cohorts were eligible. The eight RCTs had low risk of bias, and with 6311 patients they examined the effect of tocilizumab on short-term mortality; pooled RR was 0.91 (95%CI 0.78-1.07, I

conclusionsCumulative high-certainty evidence shows that tocilizumab reduces the risk of mechanical ventilation in hospitalized patients with severe COVID-19. Moderate-certainty evidence shows that tocilizumab reduces the risk of poor outcome and the risk of secondary infections in hospitalized COVID-19 patients. This review will continuously evaluate the role of tocilizumab in COVID-19 treatment.

Indexed as

COVID-19 Drug TreatmentInterleukin-6 InhibitorsAntibodies, Monoclonal, HumanizedCOVID-19HumansImmunosuppressive AgentsInterleukin-6Odds RatioPlacebosRespiration, ArtificialSARS-CoV-2Standard of CareTreatment OutcomeAntibodies, Monoclonal, HumanizedImmunosuppressive AgentsInterleukin-6Interleukin-6 InhibitorsPlacebostocilizumabCOVIDMeta-analysisOutcomeSystematic reviewTocilizumab

Identifiers

PMID33915284
PMCPMC8076756
OpenAlexW3159612864

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.