Abstract

A SYSTEMATIC REVIEW AND META-ANALYSIS OF TOCILIZUMAB (IL-6 RECEPTOR ANTAGONIST) TARGETING SEVERE CYTOKINE STORM FOR THE MANAGEMENT OF COVID-19

*Shailaja K., Vishwa Priya S. and Sri Vinithra S.

ABSTRACT

As we have managed the spread of corona virus to some extent and not completely eradicated it is essential to conduct a greater number of research to prevent and treat the COVID 19. No standard therapy is available for the treatment of COVID 19. Many drugs have been tried to treat the disease of which, monoclonal antibodies paid much attention among the researcher. So, we had an interest and conducted a systematic review to determine the potential of tocilizumab in the cytokine storm and to measure the all-cause mortality rates. A systematic literature search was conducted till May 24, 2020, in the major databases namely, PubMed, Cochrane Library, Embase, medRxiv, and bioRxiv using the search terms cytokine storm, tocilizumab, etc. PRISMA guidelines were followed. The articles that are written in the English language were included. All-cause mortality in severe COVID patients was one of the treatment outcomes. Six retrospective study reports were considered, including 220 people in the experimental group (tocilizumab) and 287 in the control group. Patients with COVID-19 in the tocilizumab group had an all-cause fatality rate of 16.3 percent (36/220), which was lower than the control group (26.8%; 77/287). The difference, however, did not reach statistical significance (RR = 0.56, 95% CI 0.26–1.21; I2 = 72%). It's possible that the non-significant differences between the tocilizumab and control groups are attributable to the tocilizumab groups’ baseline characteristics being more severe than the control groups. We conclude that Tocilizumab was effective in moderate to the early stages of severe COVID-19 patients. In the future tocilizumab recommendations for COVID-19 need evidence.

Keywords: Tocilizumab, SARS-CoV-2, COVID-19, Mortality, Cytokine storm, Interleukin-6.