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Emergency Medicine Journal COVID-19 monthly top five
  1. Daniel Horner1,2,3,
  2. John O'Rourke3,
  3. James Collins1,
  4. Daniel Darbyshire1,4,
  5. Fiona Lecky5,6
  1. 1 Emergency Department, Salford Royal NHS Foundation Trust, Salford, UK
  2. 2 Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
  3. 3 Critical Care, Salford Royal NHS Foundation Trust, Salford, UK
  4. 4 Postgraduate Department, Lancaster Medical School, University of Lancaster, Lancaster, UK
  5. 5 Health Services Research, University of Sheffield, Sheffield, UK
  6. 6 Emergency Department /TARN, Salford Royal Hospitals NHS Foundation Trust, Salford, UK
  1. Correspondence to Dr Daniel Horner, Emergency Department, Salford Royal NHS Foundation Trust, Salford, UK; danielhorner{at}

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Edited by Govind Oliver on behalf of the RCEM COVID-19 CPD team.

Following from the successful ‘RCEM weekly top five’ series starting in April 2020, this is the second of a monthly format for Emergency Medicine Journal (EMJ) readers.1 We have undertaken a focused search of the PubMed literature using a standardised COVID-19 search string. Our search between 1 and 30 November 2020 came up with 216 papers limited to human subjects and English language.

Our team has narrowed down the most interesting, relevant and important of the papers and provided a critical snapshot of five of those we felt most deserved EMJ reader attention. Importantly, we have highlighted not only the main findings from the papers but also key limitations and considerations for emergency medicine (EM) clinicians when interpreting the work. In doing so, we have created an accessible window into pertinent research findings for our busy colleagues during this fast-paced and ever-changing COVID-19 landscape.

The papers are ranked in one of three categories, allowing you to focus on the papers that are most vital to your practice:

  • Worth a peek: interesting but not yet ready for prime time.

  • Head turner: new concepts.

  • Game changer: this paper could/should change practice.

This month’s searches were undertaken by a combined EM and intensive care group working at Salford Royal NHS Foundation Trust. We look forward to next month’s instalment by our colleagues at the Centre for Urgent and Emergency Care Research (CURE), University of Sheffield.

Efficacy of tocilizumab in patients hospitalised with COVID-19

Topic: intervention

Rating: head turner

The search for a magic bullet for COVID-19 continues. The end of 2020 saw publication of a trial on the interleukin-6 antagonist tocilizumab, one of many therapies already being ‘compassionately’ used off-label, with observational data suggesting benefit.2–4

This was a double-blinded, placebo-controlled randomised trial conducted across seven sites in the USA. Hospitalised patients with …

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  • Correction notice This paper has been updated to correct Editor details. This article has been corrected since it first published. The provenance and peer review statement has been included.

  • Collaborators RCEM COVID-19 CPD Team: Charles Reynard, Anisa Jabeen Nasir Jafar, Daniel Darbyshire, Gabrielle Prager, Govind Oliver, Simon David Carley.

  • Contributors Charlie Reynard and Govind Oliver conducted literature searches. JOR and DH hand searched the grey literature and reference lists of selected papers, in addition. JOR, DH and DD sifted all abstracts and selected 5 articles for inclusion. JOR, DH, JC, DD and FL drafted summaries of individual articles. DH compiled the summaries, drafted and edited the full article for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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