ABSTRACT
OBJECTIVE: To explore the medical evidence published until April 20, 2022, about the efficacy and safety of tocilizumab in COVID-19 patients. METHODOLOGY: Scoping review that included PubMed and Scopus, searching for clinical trials and observational studies in English and Spanish. Additionally, records of clinical trials from the International Clinical Trials Registry Platform were analyzed. RESULT(S): Fifty-four documents were included: retrospective cohort studies (n = 20), randomized clinical trials (n = 16), case control studies (n = 7), non-randomized clinical trials (n = 5) and prospective cohort studies (n = 6), with a total study population of 20,007 patients. There were 15 records of clinical trials of which 10 were registered in the US National Library of Medicine. CONCLUSION(S): Tocilizumab could be effective and safe to treat patients with moderate to critical COVID-19, in conjunction with additional immunomodulators and antivirals. A greater number of randomized clinical trials, however, are needed to explore the efficacy and safety of tocilizumab.Copyright © 2023 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.
ABSTRACT
Introduction: Fibromyalgia is a syndrome characterized by chronic generalized pain, joint stiffness, sleep disorders, fatigue, anxiety and depressive episodes, whose clinical manifestations begin after a physical or emotional trauma. However, few publications describe the clinical impact of COVID-19 on fibromyalgia symptoms. Objective: To map the available medical evidence on the impact of COVID-19 and PCS in patients with and without a diagnosis of fibromyalgia prior to infection. Materials and methods: Exploratory systematic review in PubMed and Scopus, considering articles in English and Spanish, with data on fibromyalgia in the population surviving SARS-CoV-2 infection. The clinical trial records of the World Health Organization databases were reviewed. Results: Twelve published articles were included: retrospective studies (n = 4), cross-sectional (n = 2), cases and controls (n = 2), qualitative studies (n = 2), a prospective cohort (n = 1) and a longitudinal section study (n = 1). The total study population of the included publications was 3,060 patients. In addition, one randomized controlled clinical trial and two observational cross-sectional and case-control studies were included. The total sum of the study population was 173 participants. Conclusion: Survivors of COVID-19 with or without a previous diagnosis of fibromyalgia may present an increase in chronic pain, insomnia, joint stiffness, and deterioration in quality of life. The population with a history of fibromyalgia may be more affected by psychological stress, tissue damage to neuromuscular structures, and inflammation due to SARS-CoV-2 infection.