• Sridhar Chilimuri, Haozhe Sun, Ahmed Alemam, Kyoung-Sil Kang, Peter Lao, Nikhitha Mantri, Lawrence Schiller, Myroslava Sharabun, Elona Shehi, Jairo Tejada, Alla Yugay, and Suresh Kumar Nayudu.
• Department of Medicine, Bronxcare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA.
• J Clin Pharm Ther. 2021 Apr 1; 46 (2): 440-446.

What Is Known And ObjectiveThe coronavirus disease 2019 (COVID-19) associated cytokine activation can lead to a rapid progression into respiratory failure, shock and multiorgan failure. Interleukin-6 (IL-6) is a pro-inflammatory cytokine that likely contributes to the pathogenesis of cytokine release syndrome. It is hypothesized that modulating IL-6 levels or its effects with tocilizumab, a recombinant humanized anti-IL-6 receptor monoclonal antibody, may alter the course of disease.MethodsWe examined the association between tocilizumab use and intubation or death at a community hospital in New York City. Data were obtained regarding consecutive patients hospitalized with COVID-19. The primary end point was a composite of intubation or death in a time-to-event analysis. We compared outcomes in patients who received tocilizumab with those in patients who did not, using a multivariable Cox model with inverse probability weighting according to the propensity score.Results And DiscussionIn this single-centre retrospective cohort study involving 1225 hospitalized patients with SARS-CoV-2 infection, the probability to respiratory failure, which was measured as intubation or death, was less frequent in patients who received tocilizumab.What Is New And ConclusionTocilizumab and other IL-6 receptor monoclonal antibodies may evolve as a viable option in treating patients with moderate and severe COVID-19.© 2020 John Wiley & Sons Ltd.

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