ABSTRACT
Background: Tocilizumab is a humanized monoclonal antibody. It provokes inhibition of the proinfammatory signals by binding to IL-6 receptors [1]. Due to these properties, it is used in infammatory arthritis conditions and in cytokine release syndromes [2]. Notably, given its ability to intercept proinfammatory cascades, tocilizumab is an important option for patients with critical forms of COVID-19 [3]. Nevertheless, several aspects about the use of tocilizumab in this clinical setting should be better explained [4]. Objectives: This bibliometric analysis is aimed at dissecting the developed research in the subject. It could provide useful fndings for predicting the direction of future studies, implementing corrective measures, and enhancing research networks. Methods: The global literature on tocilizumab treatment for COVID-19 was scanned in the Web of Science (WOS) online database. The search terms applied to identify the closest matching articles included 'tocilizumab' and 'COVID-19'. All data were acquired on January 29, 2022. The information for the documents that met the requirements were extracted. The source was Journal Citation Reports™ 2020 (Clarivate Analytics). The literature analysis and knowledge visualization software tool VOSviewer (version 1.6.17) was used to analyze the co-occurrence of keywords (interconnection), co-citation (bibliographic coupling), co-citation analysis for sources, and countries, and analysis of the most productive organizations and networks. Results: A total of 1019 articles on tocilizumab treatment for COVID-19 patients were published from 2020 to January 2022, in WOS. Of those: 462 in 2020, 546 in 2021, 11 on January 29, 2022. About article types, 697 were research articles, 322 reviews. The analysis of keywords provided by authors showed that of 50 keywords, 17 met the threshold (interconnection 2). The most frequent keywords were EFFICACY, and OFF-LABEL USE (Figure 1) For the co-citation study, we used cited sources (journals) as unit (minimum numbers of citations of a source 1, maximum 3). Of 45 sources, 27 met the threshold. For each source, the total strength of the co-citation links with other sources was rated. The minimum number of documents per country was 2. Thus, 23 countries met the threshold. The largest number of partnerships regarded the US, and Italy. The analysis of affiliations was conducted by considering the cut-off 1 and 5 as the minimum and maximum number of documents. Out of 151 organizations, 94 met the threshold. Conclusion: This bibliometric network analysis on tocilizumab treatment for COVID-19 patients can be useful for planning future research. It highlights the strength of representative scholars and core research teams. Additional networks should be built, and high-value clinical studies are needed.
ABSTRACT
Background: Ensuring treatment continuity during the COVID-19 pandemics was a major commitment of our Institution. To this end a specific response plan, integrating recommendations from relevant networks (AIOM, NCCN, ISS, ANIPIO, FNOPI), was implemented to minimize exposure risks and fatality rates for patients (pts.) and personnel. Methods: From March 10, triage checkpoints at hospital main entrances were activated to regulate access to wards, outpts. chemotherapy facility and diagnostics units (A). From April, additional stations were established at further building allocating outpts. clinics and surgical day care (B). Nursing staff was involved in several intervention domains: 1. development and updating of triage forms for pts. and caregivers (10 updates). 2. Education and guidance on personal protective equipment (PPE). 3. regulation of inflow at triage stations. This was achieved through a specific protocol including support for access forms compilation, collection of travel/contact history, thermoscan survey, monitoring of peripheral oxygen saturation for unfit patients, direct interaction with referral physicians through point-of-care (POC) audits to secure access for symptomatic patients and 'suspect COVID-19 cases' in need of non-deferrable treatments. These POC audits were mainly aimed at separating cancer and treatment-symptoms from indicators of possible SARS-CoV-2 infection. 4. Nasopharyngeal swabbing for personnel and 'suspect cases' at POC and within a precautionary program for all immunocompromised petients accessing the hematology-oncology Unit. 5. From May 15, setup and administration of rapid testing for SARS-CoV-2 IgG/IgM with POC nasopharyngeal swabbing for those displaying positive antibody results. 6. Health education for pts., caregivers, personnel and outsourcing operators, including hand hygiene, selection and use of PPE. Results: Overall results (March-May 2020), are shown below. Conclusions: Efforts made by nursing team significantly contributed to warrant oncology care continuity and operators safety. Nursing triage effectively identified potential SARS-CoV-2 carriers.