Tocilizumab and COVID-19: a meta-analysis of 2120 patients with severe disease and implications for clinical trial methodologies

BACKGROUND/AIM: Since the outbreak of the COVID-19, numerous therapies to counteract this severe disease have emerged. The benefits of Tocilizumab for severely infected COVID-19 patients and the methodologies of ongoing clinical trials are explored. MATERIALS AND METHODS: A systematic search adhering to PRISMA guidelines was conducted in PubMed, Cochrane Central, medRxiv, and bioRxiv using the following keywords: “Tocilizumab,” “Actemra,” “COVID-19.” An additional subsearch was conducted on Clinicaltrials.gov to locate ongoing tocilizumab trials. RESULTS: A total of 13 studies were included in the meta-analysis comprising 2120 patients. The treatment group had lower mortality compared to the control group (OR = 0.42, 95% CI = 0.26 to 0.69, P = 0.0005, I2 = 55%). A descriptive analysis of 50 registered trials was conducted. CONCLUSION: This review meta-analyzed the therapeutic benefits of tocilizumab in COVID-19 patients with severe disease for mortality, mechanical ventilation, and the characteristics of COVID-19 registered trials.