Granulocyte-macrophage colony-stimulating factor (GM-CSF) antibodies treatment for COVID-19 patients: a meta-analysis
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Abstract
Objective
We performed a meta-analysis in order to determine safety of granulocyte-macrophage colony-stimulating factor (GM-CSF) antibodies on COVID-19.
Methods
We searched from the Cochrane Library, PubMed, Embase, biorxiv and medrxiv databases beginning in the COVID-19 outbreak on December 1, 2019 until August 29, 2021. The primary outcomes included death, the incidence of invasive mechanical ventilation (IMV), ventilation requirement, and secondary infection.
Results
6 eligible literature involving 1501 COVID-19 patients were recruited, and they were divided into experimental group (n = 736) and control group (n = 765). Using a random-effect model, we found that the GM-CSF antibodies treatment was associated with a 3.8-26.9% decline of the risk of mortality[odd’s ratio (OR) = 0.06, 95% confidence interval (CI): -0.11, -0.01, p =0.02], a 5.3-28.7% reduction of incidence of IMV [OR = 0.51, 95% CI: 0.28, 0.95, p =0.03], and a 23.3-50.0% enhancement of ventilation improvement [OR = 11.70, 95% CI: 1.99, 68.68, p=0.006]. There were no statistically significant differences in the association between two groups in second infection.
Conclusion
Severe COVID-19 patients may benefit from GM-CSF antibodies.
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SciScore for 10.1101/2022.01.07.22268878: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization Assessment of study quality: Study quality was assessed using the Newcastle-Ottawa Scale (NOS) 7 (Supplemental Table 1) for nonrandomized studies and the Cochrane risk-of-bias tool (Supplemental Figure 1) for randomized control trials (RCTs). Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources Briefly, literature concerning GM-CSF antibody treatment alone, or in combination with other specific treatments, of adult COVID-19 patients were included. GM-CSFsuggested: (BioLegend Cat# 741142, RRID:AB_2895550)Software and Algorithms Sentences Resources W, Then, the duplicate literatures were … SciScore for 10.1101/2022.01.07.22268878: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization Assessment of study quality: Study quality was assessed using the Newcastle-Ottawa Scale (NOS) 7 (Supplemental Table 1) for nonrandomized studies and the Cochrane risk-of-bias tool (Supplemental Figure 1) for randomized control trials (RCTs). Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources Briefly, literature concerning GM-CSF antibody treatment alone, or in combination with other specific treatments, of adult COVID-19 patients were included. GM-CSFsuggested: (BioLegend Cat# 741142, RRID:AB_2895550)Software and Algorithms Sentences Resources W, Then, the duplicate literatures were excluded using EndNote X7; Only eligible literature with full text included. EndNotesuggested: (EndNote, RRID:SCR_014001)The search strategy was ran by J.G. and W.W. in the Cochrane Library, Embase, PubMed, and biorxiv and medrxiv. Cochrane Librarysuggested: (Cochrane Library, RRID:SCR_013000)Embasesuggested: (EMBASE, RRID:SCR_001650)PubMedsuggested: (PubMed, RRID:SCR_004846)Assessment of study quality: Study quality was assessed using the Newcastle-Ottawa Scale (NOS) 7 (Supplemental Table 1) for nonrandomized studies and the Cochrane risk-of-bias tool (Supplemental Figure 1) for randomized control trials (RCTs). Cochranesuggested: (Cochrane Library, RRID:SCR_013000)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Several limitations in our meta-analysis should be noted as follows: (1) because of limited number of cases and studies, the quality of all cohort-study-based evidences and most RTC-based evidences are low, especially for the improvement of ventilation and the incidence of IMV; We believe that low-powered analysis of this parameter based on a small number of studies can still provide useful insights by highlighting a deficiency in a particular topic that deserves further attention. (2) There are differences in the standard of care used (for placebo/GM-CSF inhibitor arms) in the included studies, which limits our capability to perform an adequate comparison and meta-analysis of these studies. For example, differences in the oxygen therapy and nursing measures may influence the mortality in COVID-19 patients. (3) One of the six studies used for the meta-analysis are pre-publications without peer-review, which may imply a risk of publication bias or other potential risks. (4) Study population is different for some studies, which implies a risk of selection bias; (5) Besides, there are some other factors in this study, such as other drugs, ventilator availability, and vaccines. For example, the effectiveness of dexamethasone in COVID-19 has been previously reported.21 So, the synergistic effect or other interactions of these factors (such as dexamethasone) remains unclear. Therefore, the clinical interpretation of these findings is limited by these high or unclear risks of bias. ...
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04492514 Recruiting Mavrilimumab to Reduce Progression of Acute Respiratory Fail… NCT04351152 Active, not recruiting Phase 3 Study to Evaluate Efficacy and Safety of Lenzilumab … Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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