Low-dose tocilizumab is associated with improved outcome and a low risk of secondary infection in severe COVID-19 pneumonia.

Background Respiratory failure and death are the leading causes of severe Coronavirus disease 2019 (COVID-19). Hyper-inflammation and cytokine storm cause lung damage. This study aimed to compare the low-dose and high-dose effects of tocilizumab, an IL-6 receptor antagonist. Method Patients with severe pneumonia and hyper-inflammation signs due to COVID-19 were included in this retrospective study. Patients receiving tocilizumab Results A total of 160 patients were included in the study; 70 were treated with a low dose and 50 with high dose tocilizumab. Forty patients were in the control group. Age, comorbidity, and clinical features were similar in the control, low-dose tocilizumab, and high-dose tocilizumab groups. The mortality rate (12.9%, 30.0%, 37.5, p = 0.008) was less in the low-dose tocilizumab group. The secondary infection rate was higher in the high-dose group than in the low-dose tocilizumab and control groups (44.0%, 10.0%, 10.0%, p Conclusion The use of tocilizumab at a low dose is associated with lower secondary infections and mortality.