Background In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov ( NCT04381936 ). Findings Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research.

Human papillomavirus (HPV) is now known to be a risk factor for the development of cervical cancer. This study examines women's knowledge of cervical screening and dysplasia and HPV. The entire female work force of a medium-sized UK university received a questionnaire concerning knowledge of cervical screening, treatment for abnormalities and HPV. Four hundred women returned completed questionnaires. Knowledge of early cervical cancer detection and screening methods was good. However, risk factors for cervical cancer were not well known. Awareness and knowledge of HPV was very limited. Past experience of an abnormal smear result and colposcopy was significantly associated with good knowledge of cervical screening, but not with knowledge of HPV. It is essential to improve women's understanding of this area in the context of plans to include screening for HPV in the UK's national cervical screening programme.

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The main objective of this prospective randomised study was to evaluate whether offering pre-colposcopy group sessions reduces anxiety at the time of colposcopy. We also examined whether this strategy improved knowledge about abnormal smears and colposcopy and improved satisfaction with the colposcopy service provided. One hundred and forty-seven women undergoing colposcopy for the first time were randomised into two groups. The control group (n = 75) received conventional management. The study group (n = 72), in addition to conventional management, were invited to attend a pre-colposcopy group session led by a trained colposcopy nurse. Questionnaires were used to determine state anxiety inventory scores and knowledge scores at the time of randomisation, immediately before colposcopy and 6 weeks after the clinic visit. Satisfaction questionnaires were completed 6 weeks after the clinic visit. We found that women attending colposcopy clinics are anxious. Those women who attended the pre-colposcopy session had improved knowledge scores (P = 0.039) at the time of colposcopy and satisfaction (P = 0.037). However, the intervention failed to significantly reduce anxiety at the time of colposcopy (P > 0.05).

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