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EMJ COVID-19 monthly top five
  1. Ronan Callanan1,
  2. Conor Deasy1,
  3. Joe Slowey1,
  4. Rory O’ Brien1,
  5. Mike Dunphy1,
  6. Kanti Dasari1,
  7. Tom Brennan1,
  8. Simon Walsh1,
  9. Stephen Gilmartin1,
  10. Iomhar O' Sullivan1,
  11. Gabrielle Prager2
  1. 1 Department of Emergency Medicine, Cork University Hospital, Cork, Ireland
  2. 2 Emergency Department, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK
  1. Correspondence to Dr Ronan Callanan, Emergency Medicine, Cork University Hospital, Cork, Ireland; ronancallanan{at}

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Following from the successful ‘RCEM weekly top five’ series starting in April 2020, this is the seventh of a monthly format for EMJ readers. We have undertaken a focused search of the PubMed literature using a standardised COVID-19 search string. Our search between 1 April 2021 and 30 April 2021 returned 3139 papers limited to human subjects and English language. We also searched high impact journals for papers of interest.

Our team have 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 key limitations and considerations for emergency medicine 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 the Emergency Innovation Research Network (EIRN) at Cork University Hospital Emergency Department, Ireland. We look forward to next month’s instalment by our colleagues from the Emergency Medicine Research Group Edinburgh.

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Topic: treatment

Rating: game changer

The Randomised Evaluation of COVID - 19 Therapy (RECOVERY) trial is a large randomised control trial that has been evaluating potential COVID-19 treatments in hospitalised patients in the UK NHS.1 It has now evaluated the effect of tocilizumab in patients with severe COVID-19 characterised by hypoxia and substantial inflammation. Tocilizumab is an anti-interleukin-6 receptor antibody, it may mitigate the hyperinflammatory response and associated cytokine ‘storm’ seen in severe COVID-19. …

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  • Contributors All of the authors contributed to this review.

  • 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, or conduct, or reporting, or dissemination plans of this research.

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