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\begin{document}

\title{A systematic review and meta-analysis on the safety and efficacy of
tocilizumab in the management of COVID-19}



\author[1]{Gollapalle Lakshminarayanashatry Viswanatha}%
\author[2]{CH K V L S N  Anjana Male}%
\author[1]{Hanumanthappa Shylaja}%
\affil[1]{Independent Researcher.}%
\affil[2]{Department of Pharmaceutical chemistry and Phytochemistry, Nirmala College of Pharmacy, Mangalagiri -522503, Andhra Pradesh}%


\vspace{-1em}



  
  \date{May 22, 2024}


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\begin{abstract}
Objective: This systematic review and meta-analysis was aimed to
evaluate the therapeutic benefits and safety of tocilizumab (TCZ) in
treating severe coronavirus disease 2019 (COVID-19) and associated
health complications. Methods: The electronic search was performed using
PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials
(RCTs) and Google scholar databases to identify the randomized control
trials. Mortality, incidences of ICU admission, need of mechanical
ventilation (MV), length of stay in the hospital (LOS) and length of
stay in the ICU (LOS-ICU) and the incidences of super-infection,
bacteraemia, fugleman, pneumonia and pulmonary thrombosis were evaluated
as the primary outcomes. The comparison will be between TCZ versus
standard of care (SOC)/placebo. Results: Based on the inclusion criteria
there were 24 retrospective studies involving 5686 subjects were
included. The outcomes of the meta-analysis have revealed that the TCZ
has reduced the mortality (Mantel-Haenszel (M-H), random effects risk
difference (RE-RD) of -0.11 (-0.18 to -0.04), at 95\% CI, p = 0.001, I2
= 88\%) and increased the incidences of super-infections (M-H, RE-Risk
ratio (RR) of 1.49 (1.13 to 1.96) at 95\% CI, p=0.004, I2 = 47\%).
However, there is no significant difference in ICU admissions rate, need
of MV, LOS, LOS-ICU, and incidences of pulmonary thrombosis compared to
SOC/control. Conclusion: Based on the outcomes of the meta-analysis we
can conclude that administration of TCZ would reduce the risk of
mortality, and however there is no much difference observed between the
TCZ and SOC/control groups in other parameters.%
\end{abstract}%



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\verb`Manuscript.doc`  available at \url{https://authorea.com/users/469900/articles/562426-a-systematic-review-and-meta-analysis-on-the-safety-and-efficacy-of-tocilizumab-in-the-management-of-covid-19}

\textbf{Hosted file}

\verb`Table 1. Description of included studies.doc`  available at \url{https://authorea.com/users/469900/articles/562426-a-systematic-review-and-meta-analysis-on-the-safety-and-efficacy-of-tocilizumab-in-the-management-of-covid-19}

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