International Journal of Basic & Clinical Pharmacology | July-August 2022 | Vol 11 | Issue 4 Page 323 International Journal of Basic & Clinical Pharmacology Srikumar S et al. Int J Basic Clin Pharmacol. 2022 Jul;11(4):323-330 http://www.ijbcp.com pISSN 2319-2003 | eISSN 2279-0780 Systematic Review Role of tocilizumab therapy in COVID-19 patients: a systematic review Shabarini Srikumar 1 *, Aravind Muthiah 1 , Shridharan Perumal 2 INTRODUCTION The Corona virus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome virus (SARS CoV 2) is an ongoing global crisis that has created an adversity for the entire human community. The medical community suffer even more with the indispensable need to manage the situation. 1 With numerous studies conducted to understand the pathogenic mechanisms of the disease, it was discovered that not all COVID-19 patients were critical. The heterogenous clinical presentation varies from majority of those infected being asymptomatic or with mild symptoms and the vulnerable population like the elderly, patients with comorbidities and immunosuppressed patients getting highly affected to an extent of requiring mechanical ventilation or even death. 2- 4 The process that occurs in them making the disease a fatal one is called the ‘cytokine storm’. It is the gushing of inflammatory mediators like cytokines and interleukins, especially the interleukin 6 to the infected cells to elicit the immune response. Ironically, the overt immune response is what harms the patient more. 5 The next snag was to identify a therapeutic measure to subside the chaos. Alongside the trial of various antivirals and corticosteroids, tocilizumab, a humanized monoclonal antibody was also attempted. Tocilizumab is an interleukin 6 (IL-6) receptor antagonist. It is potent enough to bind both the membrane and soluble IL-6 receptors, thereby blocking IL-6 signalling and reducing inflammation.6 DOI: https://dx.doi.org/10.18203/2319-2003.ijbcp20221599 1 Medical scholar, Tirunelveli Medical College, Tamil Nadu, India 2 Associate Professor of Medicine, Government Pudukottai Medical College, Tamil Nadu, India Received: 08 May 2022 Accepted: 13 June 2022 *Correspondence: Dr. Shabarini Srikumar, Email: shabarini.srikumar@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Coronavirus disease 2019 (COVID-19) caused by the Severe acute respiratory syndrome coronavirus-2 (SARS CoV 2) virus has created a global threat to the entire human population. The medical and scientific community are striving hard to find an effective therapeutic strategy to overcome this crisis. There are few studies showing the efficacy of tocilizumab against COVID-19, but they many of them lack reliability due to their small sample size or sample population not representative of the general population. This meta-analysis aims to elucidate the role of tocilizumab in the management of COVID-19, its efficacy and safety profile. A comprehensive search of databases including PubMed, Medline, Cochrane, Lancet, Google Scholar, WHO, Embase, Elsevier and other modalities of search like website searching and citation tracking was carried out through which 1061 articles were identified. Among them, 10 articles that fitted the inclusion criteria and qualitatively good were taken up for the meta-analysis. Out of the 10 studies selected, the results of 9 studies were in favour of the efficacy of tocilizumab therapy, while 1 study was against the efficacy of tocilizumab. The result of our statistical analysis was that OR=0.5569 (95% CI; 0.2289 to 0.9332) for the effect of tocilizumab on mortality reduction in COVID-19 patients. Among critically ill patients with COVID-19, the in-hospital mortality was significantly reduced in patients treated with tocilizumab during the first 2 days of ICU admission compared to patients those who were not administered with tocilizumab in the early phase. Treatment with tocilizumab significantly reduces the mortality rate, increases the survival rate and lowers the risk of requiring invasive mechanical ventilation. Keywords: Corona virus disease, IL-6 receptor antagonist, Pharmacotherapy, SARS CoV 2, Tocilizumab