Beneficial and Harmful Outcomes of Tocilizumab in Severe COVID-19: A Systematic Review and Meta-Analysis

摘要: Background: Pending for randomized control trials, the use of tocilizumab (TCZ) in COVID-19 is based on observational studies and remains controversial. Purpose: To summarize evidence about effect TCZ to treat severe COVID-19. Data sources: PubMed (via MEDLINE), Scopus, medRxiv repository databases from 1 January 21 August 2020. Study Selection: Observational any language reporting efficacy safety outcomes hospitalized adults with Extraction: Independent, dually performed data extraction quality assessments. Data synthesis: Of 57 eligible studies, 27 were controlled 30 not. The overall included patients 8,128: 4,021 treated TCZ, addition standard care (SOC), 4,107 only receiving SOC. pooled mortality was lower TCZ-group vs. group, a relative risk (RR) 0.73 (95%CI 0.57-0.93; p=0.010). NNT avoid one death 20. In hospital wards, transferred intensive unit (ICU) higher proportion than those group; however, ICU group. Secondary infections occurred TCZ-treated patients. Among survivors, length stay similar both groups. Limitations: Conclusions should be considered as weak since they are most them retrospective. A variety factors influencing indication could not evaluated in-depth. Conclusions: seem beneficial preventing in-hospital severe, non-critically ill Conversely, appear at secondary infections, especially admitted ICU.