Supplementary Data — Tocilizumab for COVID-19: real-time meta analysis of 47 studies

@CovidAnalysis, November 2025, Version 26V26
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ SMACORE Colaneri (PSM) 18% 0.82 [0.07-3.41] death 5/21 19/91 Improvement, RR [CI] Treatment Control SMACORE Colaneri (PSM) 88% 0.12 [0.00-2.57] ICU 3/21 12/91 Ip 24% 0.76 [0.57-1.00] death 134 (n) 413 (n) Rojas-Marte 21% 0.79 [0.60-1.05] death 43/96 55/97 Campochiaro 53% 0.47 [0.18-1.20] death 5/32 11/33 Campochiaro -106% 2.06 [0.41-10.5] ventilation 4/32 2/33 Campochiaro 27% 0.73 [0.42-1.27] no disch. 12/32 17/33 Campochiaro 21% 0.79 [0.41-1.54] no improv. 10/32 13/33 Somers (PSW) 45% 0.55 [0.33-0.90] death 78 (n) 76 (n) Carvalho -166% 2.66 [0.32-5.52] death 5/29 4/24 Maeda 0% 1.00 [0.27-3.72] death 23 (n) 201 (n) Gokhale 38% 0.62 [0.38-0.99] death 70 (n) 91 (n) Kewan -23% 1.23 [0.22-6.76] death 3/28 2/23 Kewan -40% 1.40 [0.80-2.43] no disch. 17/28 10/23 Kewan 30% 0.70 [0.43-1.15] ventilation time 28 (n) 23 (n) Kewan -57% 1.57 [0.84-2.93] hosp. time 28 (n) 23 (n) Pettit -71% 1.71 [1.00-2.91] death 29/74 17/74 Guaraldi 62% 0.38 [0.17-0.83] death 13/125 73/179 Guaraldi 39% 0.61 [0.40-0.92] death/int. 125 (n) 179 (n) Menzella 45% 0.55 [0.22-1.35] death 41 (n) 38 (n) Menzella 56% 0.44 [0.22-0.89] death/int. 41 (n) 38 (n) Okoh -167% 2.67 [0.66-10.8] death 4/20 3/40 Okoh -344% 4.44 [1.34-14.8] ICU 10/30 3/40 Guisado-Vasco -140% 2.40 [1.13-5.11] death 132 (n) 475 (n) Rossi (PSM) 64% 0.36 [0.18-0.70] death 84 (n) 84 (n) Rossi (PSM) 60% 0.40 [0.23-0.70] death/int. 84 (n) 84 (n) Patel 9% 0.91 [0.45-1.83] death 21 (n) 21 (n) Patel 33% 0.67 [0.22-2.03] death 4/21 6/21 Patel -11% 1.11 [0.45-2.74] death 7/21 6/20 Chilimuri 60% 0.40 [0.20-0.77] death/int. 83 (n) 685 (n) Kimmig -82% 1.82 [0.96-3.47] death 19/54 11/57 Masiá 80% 0.20 [0.04-0.93] death 2/76 8/62 Masiá 8% 0.92 [0.38-2.24] ICU 9/76 8/62 Masiá -44% 1.44 [1.18-1.77] hosp. time 76 (n) 62 (n) Masiá (PSM) -68% 1.68 [0.36-7.81] viral+ 29 (n) 29 (n) Langer-Gould -117% 2.17 [0.05-5.56] death 24/52 9/41 OT​1​ Biran (PSM) 29% 0.71 [0.56-0.89] death 205 (n) 416 (n) Tsai (PSM) 0% 1.00 [0.57-1.75] death 18/66 18/66 Roumier 32% 0.68 [0.31-1.48] death 49 (n) 47 (n) Roumier 42% 0.58 [0.36-0.94] ventilation 49 (n) 47 (n) Roumier 45% 0.55 [0.36-0.82] no disch. 49 (n) 47 (n) Hill 43% 0.57 [0.21-1.52] death 43 (n) 45 (n) Hill 8% 0.92 [0.38-2.22] no improv. 43 (n) 45 (n) Canziani 18% 0.82 [0.42-1.58] death 64 (n) 64 (n) TOCICOV Ruiz-Antorán (PSW) 26% 0.74 [0.62-0.89] death 268 (n) 238 (n) BACC Bay Stone (DB RCT) -52% 1.52 [0.41-5.61] death 9/161 3/82 BACC Bay Stone (DB RCT) 35% 0.65 [0.26-1.62] ventilation 11/161 8/82 BACC Bay Stone (DB RCT) 17% 0.83 [0.38-1.81] death/int. 17/161 10/82 BACC Bay Stone (DB RCT) -11% 1.11 [0.59-2.10] progression 31/161 14/82 Wang (RCT) 27% 0.73 [0.32-1.66] progression 7/24 8/20 Wang (RCT) 54% 0.46 [0.09-2.32] no recov. 2/34 4/31 Wang (RCT) 79% 0.21 [0.05-0.87] no recov. 2/24 8/20 Wang (RCT) -8% 1.08 [0.92-1.28] hosp. time 34 (n) 31 (n) Wang (RCT) -6% 1.06 [0.88-1.28] viral time 34 (n) 31 (n) Gupta 29% 0.71 [0.56-0.92] death 433 (n) 3,491 (n) RCT-TCZ-COVID-19 Salvarani (RCT) -110% 2.10 [0.20-22.6] death 2/60 1/63 RCT-TCZ-COVID-19 Salvarani (RCT) -26% 1.26 [0.41-3.91] ICU 6/60 5/63 RCT-TCZ-COVID-19 Salvarani (RCT) -26% 1.26 [0.41-3.91] no disch. 6/60 5/63 RCT-TCZ-COVID-19 Salvarani (RCT) -5% 1.05 [0.59-1.86] no disch. 17/60 17/63 CORIMUNO-TOCI-1 Hermine (RCT) 7% 0.93 [0.36-2.42] death 7/63 8/67 CORIMUNO-TOCI-1 Hermine (RCT) -24% 1.24 [0.44-3.49] death 7/63 6/67 CORIMUNO-TOCI-1 Hermine (RCT) 62% 0.38 [0.15-0.99] ventilation 5/63 14/67 CORIMUNO-TOCI-1 Hermine (RCT) 34% 0.66 [0.39-1.15] progression 15/63 24/67 EMPACTA Salama (DB RCT) -22% 1.22 [0.62-2.38] death 26/249 11/128 EMPACTA Salama (DB RCT) 44% 0.56 [0.33-0.97] death/int. 249 (n) 128 (n) TOCIBRAS Veiga (RCT) -130% 2.30 [0.94-5.61] death 14/65 6/64 TOCIBRAS Veiga (RCT) 1% 0.99 [0.65-1.49] no recov. 65 (n) 64 (n) Fisher -4% 1.04 [0.27-3.75] death 45 (n) 70 (n) Martínez-Sanz 35% 0.65 [0.19-2.25] death n/a n/a Martínez-Sanz 66% 0.34 [0.17-0.71] death n/a n/a Martínez-Sanz -21% 1.21 [0.65-2.23] death n/a n/a SAMI-COVID Rodríguez-.. (PSM) 78% 0.22 [0.05-0.96] death 88 (n) 176 (n) SAMI-COVID Rodríguez-.. (PSM) 58% 0.42 [0.19-0.92] death/int. 88 (n) 176 (n) COVACTA Rosas (DB RCT) -1% 1.01 [0.68-1.52] death 58/294 28/144 COVACTA Rosas (DB RCT) 24% 0.76 [0.53-1.09] ventilation 51/183 33/90 COVACTA Rosas (DB RCT) 41% 0.59 [0.37-0.94] ICU 27/127 23/64 COVACTA Rosas (DB RCT) 22% 0.78 [0.54-1.12] recov. time 294 (n) 144 (n) REMAP-CAP Gordon (RCT) 22% 0.78 [0.63-0.97] death 98/350 127/355 De Rosa -41% 1.41 [0.66-2.99] death 97 (n) 1,239 (n) COVINTOC Soin (RCT) 29% 0.71 [0.34-1.46] death 11/91 15/88 COVINTOC Soin (RCT) -4% 1.04 [0.52-2.09] ventilation 14/91 13/88 COVINTOC Soin (RCT) 30% 0.70 [0.30-1.67] progression 8/91 11/88 COVINTOC Soin (RCT) -7% 1.07 [0.91-1.27] ICU 71/91 64/88 RECOVERY Horby (RCT) 13% 0.87 [0.79-0.96] death 694/2,022 815/2,094 RECOVERY Horby (RCT) 12% 0.88 [0.81-0.96] death 621/2,022 729/2,094 RECOVERY Horby (RCT) 21% 0.79 [0.69-0.92] ventilation 265/1,754 343/1,800 RECOVERY Horby (RCT) 14% 0.86 [0.81-0.92] no disch. 872/2,022 1,050/2,094 CORIMUNO-TOCI-2 Hermine (RCT) 33% 0.67 [0.30-1.49] death 49 (n) 43 (n) Ho -290% 3.90 [2.96-5.13] death Talaschian (DB RCT) -40% 1.40 [0.45-4.37] death 5/17 4/19 Talaschian (DB RCT) 47% 0.53 [0.17-1.59] no disch. 17 (n) 19 (n) Talaschian (DB RCT) -40% 1.40 [0.45-4.37] no recov. 5/17 4/19 Talaschian (DB RCT) -11% 1.11 [0.66-1.87] recov. time 17 (n) 19 (n) Yen -58% 1.58 [0.98-2.57] death 67 (n) 2,129 (n) COVIDOSE-2 Reid (RCT) -56% 1.56 [0.17-14.3] death 3/50 1/26 COVIDOSE-2 Reid (RCT) 66% 0.34 [0.01-7.92] death 0/25 1/26 COVIDOSE-2 Reid (RCT) -212% 3.12 [0.35-28.0] death 3/25 1/26 COVIDOSE-2 Reid (RCT) -2% 1.02 [0.59-1.77] recov. time 25 (n) 26 (n) COVIDOSE-2 Reid (RCT) 20% 0.80 [0.62-1.04] recov. time 25 (n) 26 (n) COVIDOSE-2 Reid (RCT) -40% 1.40 [0.89-2.20] recov. time 25 (n) 26 (n) Al Mutair (ICU) 16% 0.84 [0.75-0.94] death 157/426 457/1,044 ICU patients Tocilizumab COVID-19 outcomes c19early.org November 2025 ​1​ OT: comparison with other treatment Favors tocilizumab Favors control
Fig. S1. All outcomes.
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Fig. S2. Comparison of results for RCTs versus observational studies. For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.