Publication:
Effectiveness of tocilizumab in non-intubated cases with COVID-19: a systematic review and meta-analysis

dc.contributor.coauthorKeske, Siran
dc.contributor.coauthorAkyol, Merve
dc.contributor.coauthorTanriover, Cem
dc.contributor.coauthorOzlusen, Batu
dc.contributor.coauthorAkcan, Rustu Emre
dc.contributor.coauthorGuler, Ulas
dc.contributor.coauthorSait, Bilgin
dc.contributor.coauthorKacmaz, Bahar
dc.contributor.coauthorGonen, Mehmet
dc.contributor.coauthorErgonul, Onder
dc.contributor.departmentKUISCID (Koç University İşbank Center for Infectious Diseases)
dc.contributor.departmentDepartment of Industrial Engineering
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorGüler, Orhan Ulaş
dc.contributor.kuauthorAkcan, Rüştü Emre
dc.contributor.kuauthorErgönül, Önder
dc.contributor.kuauthorAkyol, Merve
dc.contributor.kuauthorTanrıöver, Cem
dc.contributor.kuauthorÖzlüşen, Batu
dc.contributor.kuauthorGönen, Mehmet
dc.contributor.kuauthorKeske, Şiran
dc.contributor.schoolcollegeinstituteCollege of Engineering
dc.contributor.schoolcollegeinstituteResearch Center
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2025-01-19T10:32:24Z
dc.date.issued2023
dc.description.abstractPurposeTocilizumab, a monoclonal IL-6 receptor blocker, is an effective agent for severe-to-critical cases of COVID-19; however, its target patients for the optimum use need to be detailed. We performed a systematic review and meta-analysis to define its effect among severely ill but non-intubated cases with COVID-19.MethodsWe searched PubMed, Scopus, Web of Science, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Medrxiv, and Biorxiv until February 13, 2022, for non-intubated cases, and included randomized-controlled trials (RCT) based on bias assessment. The primary outcomes were the requirement of invasive mechanical ventilation and mortality. Random effect and fixed-effect models were used. The heterogeneity was measured using the chi(2) and I-2 statistics, with chi(2)p <= 0.05 and I-2 >= 50% indicating the presence of significant heterogeneity. We registered the study to the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42021232575.ResultsAmong 261 articles, 11 RCTs were included. The pooled analysis of the 11 RCTs demonstrated that the rate of mortality was significantly lower in the tocilizumab group than in the control group (20.0% and 24.2%, OR: 0.84, 95% CI 0.73-0.96, and heterogeneity I-2 = 0%. p = 0.82.). The mechanical ventilation rate was lower in the tocilizumab group than the control group (27% vs 35.2%, OR: 0.76, 95% CI 0.67-0.86, and heterogeneity I-2 = 6%. p = 0.39).ConclusionAmong non-intubated severe COVID-19 cases, tocilizumab reduces the risk of invasive mechanical ventilation and mortality compared to standard-of-care treatment.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue6
dc.description.openaccessBronze, Green Published
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.sponsorshipAcknowledgementsWe are thankful to Ertac Nebioglu from Koc University Health Sciences Library for his detailed literature search.
dc.description.volume51
dc.identifier.doi10.1007/s15010-023-02047-2
dc.identifier.eissn1439-0973
dc.identifier.issn0300-8126
dc.identifier.quartileQ1
dc.identifier.scopus2-s2.0-85159068889
dc.identifier.urihttps://doi.org/10.1007/s15010-023-02047-2
dc.identifier.urihttps://hdl.handle.net/20.500.14288/26406
dc.identifier.wos984203700002
dc.keywordsTocilizumab
dc.keywordsCOVID-19
dc.keywordsRandomized-controlled trials
dc.keywordsPneumonia
dc.keywordsNon-intubated
dc.language.isoeng
dc.publisherSpringer Heidelberg
dc.relation.grantnoErtac Nebioglu from Koc University Health Sciences
dc.relation.ispartofInfection
dc.subjectInfectious diseases
dc.titleEffectiveness of tocilizumab in non-intubated cases with COVID-19: a systematic review and meta-analysis
dc.typeReview
dspace.entity.typePublication
local.contributor.kuauthorKeske, Şiran
local.contributor.kuauthorErgönül, Mehmet Önder
local.contributor.kuauthorAkyol, Merve
local.contributor.kuauthorTanrıöver, Cem
local.contributor.kuauthorÖzlüşen, Batu
local.contributor.kuauthorAkcan, Rüştü Emre
local.contributor.kuauthorGüler, Orhan Ulaş
local.contributor.kuauthorGönen, Mehmet
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1College of Engineering
local.publication.orgunit1Research Center
local.publication.orgunit2Department of Industrial Engineering
local.publication.orgunit2KUISCID (Koç University İşbank Center for Infectious Diseases)
local.publication.orgunit2School of Medicine
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