Effects of Tocilizumab on mortality and hospital length of stay in patients with COVID-19: a systematic review and meta-analysis
DOI:
https://doi.org/10.34119/bjhrv8n1-315Keywords:
pandemic, SARS virus, humanized antibody, monoclonal, interleukin-6 mortality, length of stayAbstract
Interleukin 6 (IL-6) plays an important role in the progression of COVID-19, reinforcing the possible efficacy of treatment with Tocilizumab (TCZ). However, there is no scientific confirmation that proves the real effectiveness of TCZ on mortality or length of hospital stay in patients with SARS-CoV-2. To update the evidence on TCZ treatment in patients with COVID-19 based on a systematic review and meta-analysis. We carried out searches based on the acronym PICOS in 5 databases (PubMed, Scopus, EMBASE, Cochrane and Web of Science). The assessment of methodological quality was carried out using the Cochrane Collaboration’s tool Risk of Bias 2 (RoB-2). The certainty of the evidence was assessed by the Grading of Recommendations Assessment Development and Evaluation (GRADE approach). The quantitative analysis was conducted using the software Review Manager 5.4. Of the 327 articles identified, 12 were included. Mortality was not influenced by treatment with TCZ compared to placebo or standard treatment (RR: 0.92; 95% CI: 0.82-1.04; p=0.17; I2=0%, p=0.63), and the certainty of the evidence was low. Five studies were considered for length of hospital stay (mean difference: -2.61; 95% CI from -5.41 to 0.19; p=0.07; I2=99%, p<0.001), the cumulative evidence it was very low. The risk of bias was low in 10 included studies. TCZ was not efficient in reducing mortality in patients with COVID-19 during hospital admission, but the true effect may be substantially different from the estimated effect. For length of hospital stay, the use of TCZ in patients with COVID-19 did not show a significant reduction in length of stay.
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