BackgroundThe coagulation markers, pro-inflammatory cytokines (such as IL-2R, IL-6, IL-10, and TNF-a) and Lymphopenia are associated with the severity of COVID-19 disease. The use of anti-inflammatory agents such as corticosteroids (CS) or Tosilizumab (TCZ) has been suggested for the treatment of advanced stage of COVID-19 and reduction of mechanical ventilators and mortality. The aim of this meta-analysis is to determine the role of combination therapy with Tocilizumab and steroid in COVID-19

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... atient. Material and methodsRelevant studies were found using online international databases and suitable studies were selected and assessed by two independent researchers. The quality of all papers were determined by a checklist. Heterogeneity assay among the primary studies was evaluated by Cochran's Q test and I2 index. The statistical analyses were done using Stata ver. 14 package (StataCorp, College Station, TX, USA) software. Publication bias was estimated through the Egger's test and the impact of each study on the overall estimate was assessed by sensitivity analysis.Result 6 studies were entered into this meta-analysis. The results of these studies showed that the risk of death for COVID-19 patients treated with the combination of corticosteroids and Tocilizumab compared to Tocilizumab or [C1] control group was 0.74 (95% CI: 0.36-1.50) and 0.48(95% CI: 0.31-0.74) respectively. ConclusionThis meta-analysis showed that the risk of death in COVID-19 patients who treated with Corticosteroids and Tocilizumab was lower than Tocilizumab and control group (26% and 52% respectively).