Appropriate use of Tocilizumab in COVID-19 Infection

Abstract Objective We aimed to describe the effectiveness and optimum use of tocilizumab (TCZ) treatment by the support of clinical, laboratory, and radiologic observations. Methods All the patients were followed up in the hospital with daily interleukin-6 (IL-6), C-reactive protein (CRP), ferritin, D-dimer, complete blood count, and procalcitonin. Computerized thoracic tomography was obtained on admission, when oxygen support was necessary, and seven days after TCZ start. Disease course of the patients was grouped as severe or critical according to their clinical, laboratory, and radiologic evaluations. Results In total, 43 patients were included; 70% of the patients was male; the median age was 64 (min-max: 27-94), 6 (14%) patients were fatal. The median duration of oxygen support before the onset of TCZ was shorter among the severe patient group than the critical patient group (1 vs 4 days, p  Conclusion Earlier use of TCZ in COVID-19 infection is beneficial for survival, length of hospitalization, and duration of oxygen support. Our recommendation for the administration of TCZ is based on the increase in requirement of the oxygen support, progression in the thorax computerized tomography, and elevation of inflammation markers, including IL-6, CRP, ferritin, and D-dimer and decrease in percent of lymphocyte.