Introduction: Tocilizumab (TCZ) is an anti-interleukin-6 antibody that has been used for the treatment of severe coronavirus disease 2019 (COVID-19). However, concrete evidence of its benefit in reducing mortality in severe COVID-19 is lacking. Therefore, we performed a systematic review and meta-analysis of relevant studies that compared the efficacy of TCZ in severe COVID-19 vs. standard of care (SOC) alone. Methods: A literature search for studies that compared “tocilizumab” and “standard of care” in the treatment of COVID-19 was done using major online databases from December 2019 to June 14, 2020. Search words “Tocilizumab,” “anti-interleukin-6 antibody,” and “COVID-19” or “coronavirus 2019” in various combinations were used. Articles in the form of abstracts, letters without original data, case reports, and reviews were excluded. Data were gathered on an Excel sheet, and statistical analysis was performed using Review Manager 5.3. Results: Sixteen studies were eligible from 693 initial studies, including 3,641 patients (64% males). There were 13 retrospective studies and three prospective studies. There were 2,488 patients in the SOC group (61.7%) and 1,153 patients (68.7%) in the TCZ group. The death rate in the TCZ group, 22.4% (258/1,153), was lower than in the SOC group, 26.21% (652/2,488) [pooled odds ratio 0.57 (95% CI 0.36–0.92), p = 0.02]. There was a significant heterogeneity (inconsistency index = 80%) among the included studies. Conclusion: The addition of TCZ to the SOC might reduce mortality in severe COVID-19. More extensive randomized clinical trials are needed to validate these findings.
【저자키워드】 COVID-19, Tocilizumab, coronavirus (2019-nCoV), tocilizumab (IL-6 inhibitor), SARS-C0V-2 infection, tocilizumab (TCZ), 【초록키워드】 Treatment, Meta-analysis, review, randomized clinical trial, Efficacy, severe COVID-19, antibody, systematic review, database, heterogeneity, Retrospective study, Patient, Evidence, Combination, Odds ratio, statistical analysis, death rate, Standard of care, 95% CI, severe coronavirus disease, abstracts, reducing mortality, article, benefit, males, reduce mortality, initial, performed, addition, was performed, were used, was done, eligible, inconsistency index, TCZ, were excluded, 【제목키워드】 review, Standard,