Tocilizumab shortens time on mechanical ventilation and length of hospital stay in patients with severe COVID‐19: a retrospective cohort study

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Abstract

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  1. SciScore for 10.1101/2020.07.29.20164160: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.


    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:
    We acknowledge several limitations. Our study was designed as a retrospective cohort study at a single academic medical center with inherent limitations to generalizability of findings and potential biases. Furthermore, the limited number of patients treated with tocilizumab restricted the power to detect a significant 30-day mortality difference. A strength of the study is the 30-day follow up exceeding previous reports on immunomodulatory treatment of COVID-19 and adding further evidence to the course of disease in critically ill patients with COVID-19. In addition to that, the analysis after propensity score-based matching did not significantly alter the results, thus reducing the likelihood of measured confounders being the sole explanation of the differences in outcomes. In summary, our findings indicate that treatment with tocilizumab of critically ill patients with severe ARDS due to COVID-19 may reduce time on mechanical ventilation and overall length of stay in ICU and in hospital. Treatment appears to be safe. Data from randomized controlled trials are needed to confirm the results and establish causality.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. SciScore for 10.1101/2020.07.29.20164160: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.


    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:

    We acknowledge several limitations. Our study was designed as a retrospective cohort study at a single academic medical center with inherent limitations to generalizability of findings and potential biases. Furthermore, the limited number of patients treated with tocilizumab restricted the power to detect a significant 30-day mortality difference. A strength of the study is the 30-day follow up exceeding previous reports on immunomodulatory treatment of COVID-19 and adding further evidence to the course of disease in critically ill patients with COVID-19. In addition to that, the analysis after propensity score-based matching did not significantly alter the results, thus reducing the likelihood of measured confounders being the sole explanation of the differences in outcomes. In summary, our findings indicate that treatment with tocilizumab of critically ill patients with severe ARDS due to COVID-19 may reduce time on mechanical ventilation and overall length of stay in ICU and in hospital. Treatment appears to be safe. Data from randomized controlled trials are needed to confirm the results and establish causality.


    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.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  3. SciScore for 10.1101/2020.07.29.20164160: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.


    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:

    We acknowledge several limitations. Our study was designed as a retrospective cohort study at a single academic medical center with inherent limitations to generalizability of findings and potential biases. Furthermore, the limited number of patients treated with tocilizumab restricted the power to detect a significant 30-day mortality difference. A strength of the study is the 30-day follow up exceeding previous reports on immunomodulatory treatment of COVID-19 and adding further evidence to the course of disease in critically ill patients with COVID-19. In addition to that, the analysis after propensity score-based matching did not significantly alter the results, thus reducing the likelihood of measured confounders being the sole explanation of the differences in outcomes. In summary, our findings indicate that treatment with tocilizumab of critically ill patients with severe ARDS due to COVID-19 may reduce time on mechanical ventilation and overall length of stay in ICU and in hospital. Treatment appears to be safe. Data from randomized controlled trials are needed to confirm the results and establish causality.


    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.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  4. SciScore for 10.1101/2020.07.29.20164160: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.


    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:

    We acknowledge several limitations. Our study was designed as a retrospective cohort study at a single academic medical center with inherent limitations to generalizability of findings and potential biases. Furthermore, the limited number of patients treated with tocilizumab restricted the power to detect a significant 30-day mortality difference. A strength of the study is the 30-day follow up exceeding previous reports on immunomodulatory treatment of COVID-19 and adding further evidence to the course of disease in critically ill patients with COVID-19. In addition to that, the analysis after propensity score-based matching did not significantly alter the results, thus reducing the likelihood of measured confounders being the sole explanation of the differences in outcomes. In summary, our findings indicate that treatment with tocilizumab of critically ill patients with severe ARDS due to COVID-19 may reduce time on mechanical ventilation and overall length of stay in ICU and in hospital. Treatment appears to be safe. Data from randomized controlled trials are needed to confirm the results and establish causality.


    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.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  5. SciScore for 10.1101/2020.07.29.20164160: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.RandomizationIf confirmed in a prospective randomized trial, the substantial reduction in length of stay in ICU observed in our cohort would most likely render the intervention highly cost-efficient, with a single dose of tocilizumab (8mg/kg, adult patient of 75 kg) being priced around 3035.93 $ in the US according to recently published model (7).Blindingnot detected.Power AnalysisFurthermore, the limited number of patients treated with tocilizumab restricted the power to detect a significant 30-day mortality difference.Sex as a biological variableNotable differences between groups in the native cohort included a higher proportion of male patients in the tocilizumab group and a lower body mass index.

    Table 2: Resources

    Data from additional tools added to each annotation on a weekly basis.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.