EFFECT OF TOCILIZUMAB ON NEW ONSET ATRIAL FIBRILLATION AND MORTALITY IN COVID-19 PATIENTS: AN UMBRELLA REVIEW

Background: Tocilizumab gained scientific attention as an effective treatment strategy for patients with severe COVID-19. This umbrella review was designed to assess the effect of Tocilizumab on incidence of new-onset Atrial fibrillation and efficacy in terms of in-hospital mortality in COVID-19 patients. Methods: We analysed all systematic reviews published in PubMed from December 2019 to 15th October 2021 reporting efficacy and safety of Tocilizumab as compared to other drugs in COVID positive patients. Quantitative data was used for deriving pooled estimates through meta-analysis. Risk of bias and quality of included reviews were assessed. Results: After an initial search of 37 relevant articles, 10 articles were found eligible (total 24,385 patients). Random effect models were considered for analysis due to presence of significant heterogeneity (I2>75%). During the investigation some studies showed non-significant differences in new-onset Atrial fibrillation (P>0.05) but significantly lower mortality in patients treated with Tocilizumab. AMSTAR and GRADE analysis showed presence of low-quality studies and highlighted the need for well-defined randomized controlled trials. Conclusion: After analysis of multiple randomized clinical trials and meta-analysis studies our umbrella review demonstrates a non-significant difference in new onset of atrial fibrillation but significant reduction in total mortality with Tocilizumab treatment in severe COVID-19 patients.