Tocilizumab as treatment for COVID-19: A systematic review and meta-analysis

Table 1 Baseline characteristics of tocilizumab treated patients

Ref.	Country	Type of study	No. of pts	Median follow up (d)	Male/Female, %	Median age (yr)	CV Comorbities, %	Respiratory/diabetes %	Other/cancer, %	Other medications, %	Ventilatory status (Baseline to end of follow up, %)	ICU admission %/time to ICU admission (d)
Alattar et al[11], 2020	Quatar	Retrospective	25	14	92/8	58	12 HTN	-/48	CKD 16/4	HCQ (100), AZITRO (96), lopinavir/ritonavir (96), ribavirin (88), and INF 1-α2a (60)	56 (invasive)	100/1
Alberici et al[12], 2020	Italy	Retrospective	6	4	-	-	-	-/-	-/-	Steroids, antivirals, HCQ	33 (16 worsened)	-/-
Capra et al[13], 2020	Italy	Retrospective (with ctr arm1)	82 (n = 62 TCZ)	9	73/27	63	63 HTN	-/16	-/-	HCQ (100), lopinavir/ritonavir (100)	35.2 (27% worsened)	4.8/-
Colaneri et al[14], 2020	Italy	Retrospective with prop. score	112 (n = 21 TCZ)	7	90/10	62.3	47.6 HTN	0/9.5	19/4.7	HCQ, AZITRO, steroids (100)	-	14/-
Hassoun et al[15], 2020	United States	Retrospective	9	-	66/33	60	55 HTN	11/11	66/-	HCQ, AZITRO (100) steroids (33), antibiotics (66)	-	89/-
Klopfenstein et al[16], 2020	France	Case control	45 (n = 20 TCZ)	-	-	76.8	55 HTN/70 CVS disease	20/25	-/35	HCQ or lopinavir/ritonavir + antibiotics ± steroids (100)	-	0/-
Luo et al[17], 2020	China	Retrospctive	15	-	80/20	73	66 HTN	-/26.6	-/-	Steroids (53)	6.6 (33.3% worsened)	-/-
Quartuccio et al[18], 2020	Italy	Retrospective (with ctr arm1)	111 (n = 42 TCZ)	17.8	78.6/21.4	62.4	47.6 HTN	-/-	-/-	Antivirals (100), HCq (92.9) steroids (40); antibiotics (28.6)	65 (invasive)	57/-
Sciascia et al[19], 2020	Italy	Prospective	63	-	89/11	62.6	45	4.7/9.5	-	Lopinavir/ritonavir (71), darunavir/cobicistat (29)	95	7.9/-
Toniati et al[20], 2020	Italy	Prospective	100	10	88/12	62	62	9/17	11/6	HCQ, lopinavir/ritonavir or remdesivir, antibiotic, steroids	69 (n = 23 worsened)	43/-
Xu et al[21], 2019	China	Retrospective	21	-	86/14	56.8	57.2	9.6/23.8	CKD 4.8/-	Lopinavir/ritonavir, IFN-α, ribavirin, steroids (100)	100	-/-
Ramaswamy et al[22], 2020	United States	Case control	86 (n = 21 TCZ)	-	61.9/38.1	63.2	14.3 HTN/heart disease, AF or stroke 19.1	28.6/14.3	-/0	HCQ (81), AZITRO (23.8), steroids (42.9)	-	47.6/-
Rimland et al[23], 2020	United States	Retrospective	11	17	82/18	59	73 HTN/18 CVS	27/36	Renal or liver 18/9	HCQ (36), AZITRO (64)	54 (10% worsened)	73/-
Sanchez-Montalva et al[24], 2020	Spain	Prospective	82	-	63/37	59.1	39 HTN/6.1 heart failure/12.2 AF	23.5/19.5	Liver 1.2/-	HCQ (98.9), lopinavir/ritonavir (76.8), AZITRO (96.3), darunavir/cobicistat (25)	53 (52% worsened)	2.9/-
Wadud et al[25], 2020	United States	Case control	94 (n = 44 TCZ)	-	-/-	55.5	-	-/-	-/-	-	-	-
Campochiaro et al[26], 2020	Italy	Retrospective	65 (n = 32 TCZ)	28	91/9	64	37 HTN/12 CAD	3/12	CKD 9/6	HCQ, AZITRO, lopinavir/ritonavir (100)	91	0/-
Morena et al[27], 2020	Italy	Prospective	51	30	78.4/21.6	60	29.4 HTN/49 CVS disease	9.8/11.8	5.9/5.9	HCQ (98), antibiotics (76), lopinavir/ritonavir (82), remdesivir (42)	66.6 (33% worsened)	11.8/-
Kimmig et al[28], 2020	United States	Retrospective (with ctr arm)	60 (n = 28 TCZ)	-	46.8/53.2	63.8	53.6 HTN/43 other	35.7/14.3	14/14.3	-	-	-
Roumier et al[29], 2020	France	Compassionate use	59 (n = 30 TCZ)	8	80/20	50	20 HTN/13 CVS	13/23	33/-	HCQ (6.6), steroids (6.6)	-	23.3/-
Ip et al[30], 2020	United States	Retrospective	547 (n = 134 TCZ)	30	78/22	62	71.6 HTN and coronary arthery disease	15/35	15/9	HCQ + AZITRO (92), steroids (66)	-	100/-
Perrone et al[31], 2020	Italy	Phase 2 and expansion cohort	1221 (n = 708 TCZ3)	30	82/18	61% > 60	68 heart disease or HTN	-/15	-/-	HCQ (75), anti-retroviral (65), antibiotics (50), steroids (28)	-	16 invasive ventilation/-
Perez-Tanoira et al[32], 2020	Spain	Cohort study	562 (n = 36 TCZ)	-	-/-	-	-	-/-	-/-	-	-	-
Somers et al[33], 2020	United States	Observational	154 (n = 78 TCZ)	47	68/32	55	85 HTN or heart failure	54/13	CKD 35/-	HCQ (26), steroids (29), remdesivir (3)	56 (18 and worsened)	100/41 < 24 h, 36 > 48 h
Heili-Frades et al[34], 2020	Spain	Cohort study	4712 (n = 366 TCZ)2	-	-/-	-	-	-/-	-/-	-	-	40.7/-
Issa et al[35], 2020	France	Retrospective	10	-	100/0	66	60 HTN	-/30	-/-	HCQ (100), steroids (30)	50	70/7 d
Garcia et al[36], 2020	Spain	Retrospective	171 (n = 77 TCZ)	-	58.8/51.2	61.5	61 HTN or heart disease	10.3/15.6	-/-	Antivirals (100, steroids (50)	90	10.3/-
Ayerbe et al[37], 2020	United Kingdom	Retrospective	2075 (n = 421 TCZ)	8	-/-	-	-	-/-	-/-	-	-	-/-
Borku Uysal et al[38], 2020	Turkey	Retrospective	12	22	50/50	65.8	58 HTN	16/58	CKD 8/16	HCQ and antivirals (100), AZITRO (50), antibiotics (58)	82	17/-
Fernandez-Cruz et al[39], 2020	Spain	Retrospective	463 (n = 189 TCZ)	-	-/-	-	-	-/-	-/-	Steroids (100), other not available	-	-/-
Garibaldi et al[40], 2020	United States	Cohort study	832 (n = 39 TCZ)	-	-/-	-	-	-/-	-/-	-	-	-/-
Martínez-Sanz et al[41], 2020	Spain	Cohort study	1229 (n = 260 TCZ)	-	73/27	65	17 HTN, 8 CAD, 2 heart failure	18/15	CKD 4/-	-	-	19/6 d
Petrak et al[42], 2020	United States	Retrospective	145	-	64/36	58.1	-	-	-	Corticosteroids (60), HCQ + AZITRO (98.6)	-	-/-
Rossi et al[43], 2020	France	Case control	246 (n = 106 TCZ)	28	66/34	64	60 HTN, 23.6 CVS	16/45	-/5.7	Antibiotics (100), HCQ (83), steroids (40), lopinavir/ritonavir (0.9)	-	-/-

¹Control arm consisted in patients treated with hydroxycloroquine + lopinavir/ritonavir before tocilizumab availability.

²Hospitalized cohort only.

³Modified intent to treat analysis. CVS: Cardiovascular disease; CAD: Coronary arthery disease; AF: Atrial fibrillation; HTN: Hypertension; CKD: Chronic kidney disease; pts: Patients; HCQ: Hydroxycloroquine; AZITRO: Azitromycin; -: Not availble; TCZ: Tocilizumab; ICU: Intensive care unit.