Prospects of monoclonal antibodies in COVID-19 treatment: a systematic
review.
Abstract
We reviewed the types of monoclonal antibodies being repurposed for
COVID-19 therapeutics, the clinical outcomes and adverse effects so as
to provide evidence the bedside physicians, the health policy-makers and
the general public could employ in the COVID-19 management protocol.
This systematic review was conducted following the guidelines of
Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The
Joanna Briggs Institute’s critical appraisal checklists for evaluation
of the quality of studies were employed to assess the quality of the
different types of primary studies included in the review. Our search
strategy identified 396 potentially relevant articles which decreased to
322 after duplicates were removed. 281 articles were screened out due to
lack of relevance. The full text of the remaining 41 relevant papers
were retrieved for full text evaluation after which only 19 studies from
eight countries met our eligibility criteria and were included in the
review. Majority (42%) of the studies emanated from Italy. Also, 94.7%
of the studies used tocilizumab. A total of 698 patients were included
in all the studies with a male/female ratio of 1.94:1. 78.9% of the
studies stated patients’ co-morbidities which include hypertension
(80%), diabetes mellitus (73.3%), cardiovascular disease (53.3%) and
obesity (26.7%). 75.9% of the patients recovered. Adverse effects
reported included viral myocarditis, bacteraemia, candidaemia and
invasive aspergillosis. Monoclonal antibodies, especially tocilizumab
and eculizumab hold some promise in the treatment of the disease but
controlled clinical trials using them as monotherapy are needed to
further evaluate this finding.