Levy Library Blog

Each month Levy Library showcases the achievements of Mount Sinai faculty and researchers by highlighting an article and its altmetrics. Altmetrics are alternative measures of impact that capture non-traditional data like abstract views, article downloads, and social media activity. Our altmetrics data is provided by the PlumX platform. 

This month we highlight Tocilizumab in patients hospitalized with Covid-19 pneumonia. This article was written in part by Carlos Salama, MD and Emma Kaplan-Lewis, MD.

CITATION

New England Journal of Medicine, ISSN: 1533-4406, Vol: 384, Issue: 1, Page: 20-30

BACKGROUND

Coronavirus disease 2019 (Covid-19) pneumonia is often associated with hyperinflammation. Despite the disproportionate incidence of Covid-19 among underserved and racial and ethnic minority populations, the safety and efficacy of the anti–interleukin-6 receptor antibody tocilizumab in patients from these populations who are hospitalized with Covid-19 pneumonia are unclear.

METHODS

We randomly assigned (in a 2:1 ratio) patients hospitalized with Covid-19 pneumonia who were not receiving mechanical ventilation to receive standard care plus one or two doses of either tocilizumab (8 mg per kilogram of body weight intravenously) or placebo. Site selection was focused on the inclusion of sites enrolling high-risk and minority populations. The primary outcome was mechanical ventilation or death by day 28.

RESULTS

A total of 389 patients underwent randomization, and the modified intention-to-treat population included 249 patients in the tocilizumab group and 128 patients in the placebo group; 56.0% were Hispanic or Latino, 14.9% were Black, 12.7% were American Indian or Alaska Native, 12.7% were non-Hispanic White, and 3.7% were of other or unknown race or ethnic group. The cumulative percentage of patients who had received mechanical ventilation or who had died by day 28 was 12.0% (95% confidence interval [CI], 8.5 to 16.9) in the tocilizumab group and 19.3% (95% CI, 13.3 to 27.4) in the placebo group (hazard ratio for mechanical ventilation or death, 0.56; 95% CI, 0.33 to 0.97; P=0.04 by the log-rank test). Clinical failure as assessed in a time-to-event analysis favored tocilizumab over placebo (hazard ratio, 0.55; 95% CI, 0.33 to 0.93). Death from any cause by day 28 occurred in 10.4% of the patients in the tocilizumab group and 8.6% of those in the placebo group (weighted difference, 2.0 percentage points; 95% CI, –5.2 to 7.8). In the safety population, serious adverse events occurred in 38 of 250 patients (15.2%) in the tocilizumab group and 25 of 127 patients (19.7%) in the placebo group.

CONCLUSIONS

In hospitalized patients with Covid-19 pneumonia who were not receiving mechanical ventilation, tocilizumab reduced the likelihood of progression to the composite outcome of mechanical ventilation or death, but it did not improve survival. No new safety signals were identified. (Funded by Genentech; EMPACTA ClinicalTrials.gov number, NCT04372186.)

View the PlumX article profile

Ed Jessup, Public Services Librarian

Urban exploration and photojournalism makes for a great combination when presenting images of inner city decay, blight and sometimes surreal takes on architecture from a bygone era. The implications of this type of journalism are vast. The written word can explain a great deal but sometimes an image can capture something that words just cannot do justice. Photojournalists specializing in images through urban exploration are, in a large way, holding up a mirror to society, and capturing images that create a lot of intrigue and discomfort in to viewers. Nobody does this better than photojournalist and activist, Seph Lawless.

Seph Lawless is a burgeoning photographer, artist and activist who has really pushed the boundaries of urban exploration and photojournalism to really give people a very strong picture what is happing in America. Through his work, Lawless has really brought to the forefront how disposable things are in American culture and society. He work really points out the irreverence Americans tend to have for the past, preferring to move on, leaving ruins in its wake.

Seph Lawless has been quoted on ABC news as saying, “I want Americans to see what is happening to their country from the comfort of their suburban homes and smart phones.” If anything positive has come from our electronic world, it’s the ability to reach people in their comfort zones and force them to think and evaluate things. So my resource recommendation from beyond the stacks is Seph Lawless’s website. Here you can get a smattering of his iconic and sometimes disturbing images of the sometimes not so distant past. His photo galleries of abandoned shopping centers, storm ravaged theme parks, majestic decomposing architecture in Detroit and other places, will peak the viewer’s curiosity. More importantly his images will make the viewer ruminate on our priorities as a society.

Lawless S. SEPH LAWLESS : OFFICIAL WEBSITE. Seph Lawless. https://sephlawless.com. Published 2016. Accessed May 19, 2021.

Samantha Walsh, Manager of Information & Education Services

You may want to see if there are clinical studies that focus on healthcare disparities in your own area of interest. A combination of Boolean operators and PubMed filters can make this quick and easy!

First, access PubMed via the Levy Library homepage. You’ll see a link listed under “Popular Tools.” Next, run a search for (disparities OR disparity OR inequalities OR inequality).

There should be over 100,000 results. You’ve basically just searched for any records in PubMed that contain any of these four terms. Next, we want to limit to Clinical Studies. On the left-hand side of your screen, locate the Article Type filter. You most likely won’t see Clinical Study listed underneath, therefore you should click Additional Filters at the bottom of this column. On the pop-up, check off “Clinical Study” so that this filter appears under Article Type on your main screen. Once you click it on the search results page, your results should narrow significantly, and be comprised of mainly clinical studies & trials. 

Note: You may be wondering why you don’t need to invoke all of the study filters you see, such as “Clinical Trial Phase III” or “Observational Study.” This is due to the hierarchical, tree structure of these tags. By invoking the broad “Clinical Study” filter, you are actually searching all of the study types nested below it in the hierarchy. 

           

You’ll want to add keywords to narrow this search down to your own area of interest. You’ll do this by adding to your original keyword search using the Boolean operator AND. For example, return to the search bar at the top of the page and type AND (ovarian cancer OR gynecologic cancer OR cervical cancer). Add any synonyms that you can think of, connecting them with the operator OR. Your final search should look something like this: (disparities OR disparity OR inequalities OR inequality) AND (ovarian cancer OR gynecologic cancer OR cervical cancer).

Finally, be sure you’re sorting by Best Match. This will ensure that the most relevant studies come to the top of your results list. 

For more information on searching PubMed, visit our guide or schedule a consultation with a librarian!