Prospects of monoclonal antibodies in COVID-19 treatment: a systematic
review.
Abstract
Introduction 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. Methods 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. Results 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.
Conclusion 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.