key: cord-0931397-t712y2ts
authors: Peng, Tzu Rong; Wu, Ta Wei; Wu, An Jan
title: Effect of Subcutaneous Tocilizumab on Mortality in Patients With COVID-19: A Meta-analysis of Retrospective Cohort Studies
date: 2021-07-27
journal: Am J Ther
DOI: 10.1097/mjt.0000000000001434
sha: 103744da743cd4f5f38cc217397ad83bb2836c1e
doc_id: 931397
cord_uid: t712y2ts

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subcutaneously with a dose of 324 mg in total and 88 patients were given intravenously with a dose of 8 mg/ kg body weight, up to a maximum of 800 mg) plus standard care for hospitalized patients with severe COVID-19 pneumonia. In the study of Kaminski et al, 2 they compared the effect of subcutaneous (324 mg in total) and intravenous tocilizumab (400 mg) for hospitalized patients with COVID-19. The outcomes including 7-day mortality, 14-to 28-day mortality, and requirement for mechanical ventilation. Overall, 151 and 153 received SC TCZ and IV TCZ, respectively.

In the pooled analysis of 2 studies, the 7-day mortality rate was 23.3% (35/150) in the SC TCZ group and 19.0% (29/153) in the IV TCZ group. In addition, the 14-to 28-day mortality rate was 54.4% (81/ 149) in the SC TCZ group and 45.0% in the IV TCZ group. Pooled analysis observed no significant difference in mortality within 7 and 14-28 days of administration of SC TCZ compared with IV TCZ [pooled RR 5 1.22; 95% confidence interval (CI), 0.79-1.89; pooled RR 5 1.19; 95% CI, 0.95-1.49, respectively] ( Figure 1 ). However, the rate of mechanical ventilation in the SC TCZ group was 21.4% and that in the IV TCZ group was 16.7%. There was no significant difference in events of mechanical ventilation between the SC TCZ group and IV TCZ group (pooled RR 5 1.33; 95% CI, 0.80-2.21) (Figure 2 ).

Based on the finding of this study, the mortality within 7 and 14-28 days and events of mechanical ventilation after administration of SC TCZ compared with IV TCZ were similar. In summary, our finding indicates that SC TCZ can be a potential candidate therapeutic agent for COVID-19 patients. However, our results should be interpreted cautiously. Only 2 studies of small sample sizes were included in this analysis, and all were retrospective cohort studies. In addition, the doses of IV TCZ were different in the 2 studies. Finally, patients had severe COVID-19 pneumonia in the study by Guaraldi et To the Editor: All antipsychotics are believed to have varying degrees of anticholinergic effects and may cause urinary retention. However, risperidone-induced acute urinary retention has rarely been reported in the literature. 1 Here, we have reported a patient with major depressive

Use of subcutaneous tocilizumab in patients with COVID-19 pneumonia

Tocilizumab therapy for COVID-19: a comparison of subcutaneous and intravenous therapies

Tocilizumab in patients with severe COVID-19: a retrospective cohort study

The authors have no conflicts of interest to declare.