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10.1038/s41375-021-01264-8

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34002026!8127467!34002026
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suck abstract from ncbi


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pmid34002026      Leukemia 2021 ; 35 (6): 1661-1670
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  • Systematic review and meta-analysis of tocilizumab in persons with coronavirus disease-2019 (COVID-19) #MMPMID34002026
  • Chen CX; Hu F; Wei J; Yuan LT; Wen TM; Gale RP; Liang Y
  • Leukemia 2021[Jun]; 35 (6): 1661-1670 PMID34002026show ga
  • We performed a meta-analysis to determine safety and efficacy of tocilizumab in persons with coronavirus disease-2019 (COVID-19). We searched PubMed, Web of Science and Medline using Boolean operators for studies with the terms coronavirus OR COVID-19 OR 2019-nCoV OR SARS-CoV-2 AND tocilizumab. Review Manager 5.4 was used to analyze data and the modified Newcastle-Ottawa and Jadad scales for quality assessment. We identified 32 studies in 11,487 subjects including three randomized trials and 29 cohort studies with a comparator cohort, including historical controls (N = 5), a matched cohort (N = 12), or concurrent controls (N = 12). Overall, tocilizumab decreased risk of death (Relative Risk [RR] = 0.74; 95% confidence interval [CI], 0.59, 0.93; P = 0.008; I(2) = 80%) but not of surrogate endpoints including ICU admission (RR = 1.40 [0.64,3.06]; P = 0.4; I(2) = 88%), invasive mechanical ventilation (RR = 0.83 [0.57,1.22]; P = 0.34; I(2) = 65%) or secondary infections (RR = 1.30 [0.97,1.74]; P = 0.08; I(2) = 65%) and increased interval of hospitalization of subjects discharged alive(mean difference [MD] = 2 days [<1, 4 days]; P = 0.006; I(2) = 0). RRs of death in studies with historical controls (RR = 0.28 [0.16,0.49; P < 0.001]; I(2) = 62%) or a matched cohort (RR = 0.68 [0.53, 0.87]; P = 0.002; I(2) = 42%) were decreased. In contrast, RRs of death in studies with a concurrent control (RR = 1.10 [0.77, 1.56]; P = 0.60; I(2) = 85%) or randomized (RR = 1.18 [0.57,2.44]; P = 0.66; I(2) = 0) were not decreased. A reduced risk of death was not confirmed in our analyses which questions safety and efficacy of tocilizumab in persons with COVID-19.
  • |*COVID-19 Drug Treatment[MESH]
  • |Antibodies, Monoclonal, Humanized/adverse effects/*therapeutic use[MESH]
  • |COVID-19/mortality[MESH]
  • |Hospitalization[MESH]
  • |Humans[MESH]
  • |Intensive Care Units[MESH]
  • |SARS-CoV-2/*drug effects[MESH]


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