1.  All-cause mortality at 28 days: Very low certainty of evidence in 30 patients from 1 RCT2 including those with moderate to severe COVID-19 infection, showed that Itolizumab had a very uncertain effect on the mortality at day 28RR 0.07(95% CI 0.00 to 1.32).
  2. Patients with increasing oxygen requirements upto day 30: Very low certainty of evidence in 30 patients from 1 RCT2revealed a very uncertain effect of Itolizumab on increasing oxygen requirements RR 0.03
    (95% CI 0.00 to 0.56). This suggested a very imprecise estimate that Itolizumab reduced the proportion of those needing increased oxygen requirements upto day 30 by 97% but this could vary from 44% to 100%.
  3. Need for non- invasive/mechanical ventilation: Very low certainty of evidence in 30 patients from 1 RCT2revealed a very uncertain effect of Itolizumab on the need for NIV/mechanical ventilation upto 30 daysRR 0.07(0.00 to 1.32). This suggested a very imprecise estimate of Itolizumab reducing the need for NIV/Mechanical ventilation by 93%( 95% CI 100% reduction or 32% increase).
  4. Improvement in the PF ratio: Very low certainty of evidence in 30 patients from 1 RCT2revealed a very uncertain effect of Itolizumab on improvement in PF ratio with MD 157 higher(95% CI 132.04 to 181.96 higher).
  5. Mean D-dimer levels at day 30: Very low certainty of evidence in 30 patients from 1 RCT2revealed a very uncertain effect of Itolizumab on mean D-dimer levels at day 30; MD was 0.74 lower (95% CI 0.5 – 0.98 lower). Baseline D-dimer level was higher in the control to begin with5.15 (SD 7.85) μg/mL compared to Itolizumab arm 3.50 (SD 4.87) μg/mL. The mean D-dimer reduced to 2.83 (SD 5.46) μg/mL and 0.41 (SD 0.18) μg/mL on Days 14 and 30, respectively in the Itolizumab group. In control group, mean D-dimer was 0.86 (SD 0.71) μg/mL and 1.15 (SD 0.37) μg/mL on Days 14 and 30, respectively.
  6. Mean CRP levels at day 30: Very low certainty of evidence in 30 patients from 1 RCT2revealed a very uncertain effect of Itolizumab on the baseline CRP levels. Baseline C-reactive protein (CRP) was numerically higher in control group 103.88 (SD 87.89) mg/Lvs  73.74 (SD 71.84) mg/L in the intervention group. In the Itolizumab group, mean CRP reduced to 6.45 (SD 4.14) mg/L and 13.69 (SD 20.45) mg/L on Days 14 and 30, respectively. In the control group, mean CRP reduced to 14.36 (9.29) mg/ L and 3.05 (2.62) mg/L on Days 14 and 30, respectively. 
  7. Mean reduction in serum Ferritin levels from baseline: Very low certainty of evidence in 30 patients from 1 RCT2revealed a very uncertain effect of Itolizumab on reduction in Serum ferritin levels from baseline(Mean reduction) MD 244.9 lower(95% CI 615.13 lower to 125.33 higher). Baseline ferritin was high in Itolizumab group compared to control (943.34 ng/mL vs 577.95 ng/mL). In Itolizumab arm the mean ferritin reduced to 303.50 (SD 210.93) ng/dL and 189.22 (SD 129.96) ng/dL on Day 14 and 30, respectively. In control group, ferritin was 367.68 (SD 130.22) ng/dL and 285.25 (SD 157.76) ng/dL on Days 14 and 30, respectively. This suggested that a greater reduction from baseline was seen in serum ferritin levels in Itolizumab arm (−479.3 (620.95) ng/dL) in comparison to control (−234.4 (405.67) ng/dL) at day 30 (p-value = 0.078).
  8. Mean Serum LDH levels from baseline at day 30: Very low certainty of evidence in 30 patients from 1 RCT2revealed a very uncertain effect of Itolizumab on mean Serum LDH levels from baseline on day 30 ;MD 247.83 lower(95% CI 356.68 lower to 138.98 lower). Baseline lactate dehydrogenase (LDH) was comparable in both arms; 533.30 (SD 206.85) U/L in Arm-A and 645.30 (SD 292.79) U/L in Arm-B. In the Itolizumab arm, mean LDH reduced to 381.47 (SD 181.45) U/L and 208.67 (SD 40.72) U/L on Days 14 and 30, respectively. In the control arm, mean LDH was 330.20 (SD 91.63) U/L and 456.50 (SD 173.24) U/L on Days 14 and 30, respectively.
  9. All adverse events:Very low certainty of evidence in 30 patients from 1 RCT2revealed a very uncertain effect of Itolizumab on all adverse events. Based on the data, we anticipate that for 1000 patients with COVID-19 disease treated with placebo 400 adverse events are likely. We anticipate that there would be 420 higher (320 to 1000) adverse events per 1000 people if Itolizumab is administered for patients with COVID-19. This was due to the fact that 18 adverse events related to the drug occurred in the patients treated with Itolizumab(N=22) among those 30 patients studied in our trial. Two patients had infusion reactions with Itolizumab infusion and hence the drug was not given. Considering that this being a single trial conducted among 30 patients, of which 20 patients only received Itolizumab with high risk of bias in RoB2 tool, the evidence is very uncertain about the effect of Itolizumab on adverse events.