IL-6 Inhibition in Critically Ill COVID-19 Patients Is Associated With Increased Secondary Infections

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Abstract

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  1. SciScore for 10.1101/2020.05.15.20103531: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the University of Chicago Institutional Review Board.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableVariables that are statistically different between those were given tocilizumab and those who were not, were sex with the predominance of males in the tocilizumab group, history of transplant and use of immunosuppressive agents, and APACHE II scores were trending higher in the tocilizumab group (p=0.078, Mann-Whitney U test) (see table 1).

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    2.3 Statistical Analysis: Statistical analysis was conducted with SPSS version 26 (IBM, Armonk, NY) and R version 4 (Package Logistf).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    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:
    There are several important limitations to our study. The most important limitation is the retrospective nature and lack of randomization. Naturally, this does not allow for the establishment of causality. Because our study was retrospective, while the majority of baseline characteristics were similar, there were some that were slightly different. These include the history of transplant and use of immunosuppressive agents. Despite these limitations, patients in both groups were relatively closely matched with regards to severity of illness (APACHE II score, laboratory parameters). Patients who received tocilizumab may have developed more severe disease during the course of their ICU stay, however, our institutional policies regarding tocilizumab included important exclusion criteria, including LFT abnormalities, suspected ongoing infection, and enrollment in a clinical trial (e.g. remdesivir). In light of these limitations, it appears unlikely that the group receiving tocilizumab was excessively enriched with the sickest patients and gives credence to the descriptive power of the severity of illness captured by APACHE II scoring. While the non-tocilizumab group did not have any patients with transplantation and all patients with history of transplantation were in the tocilizumab group, history of transplantation did not affect the outcomes. Furthermore, it should be noted that the mortality data herein should be considered preliminary, because some patients were still hospita...

    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.