6.2.2  Rationale: Tocilizumab can treat lung injury in patients with critical and severe COVID-19
In the study [27], 21 patients with COVID-19 whose condition was severe or critical received one or two doses of Tocilizumab plus standard therapy. Patients who had a mean IL6 level of more than 100 pg/ml before tocilizumab treatment showed improvement in clinical symptoms and peripheral oxygen saturation and normalization for lymphocyte proportion and CRP levels. Also, lung lesion opacity was absorbed in 90% of patients. Neither serious adverse effects nor deaths occurred with tocilizumab treatment.
There are ongoing clinical trials for tocilizumab treatment in patients with moderate and severe COVID-19. Currently, the use of Tocilizumab is recommended for patients with COVID-19 who have warning signs of hyper inflammation, as can be measured by IL6, ferritin, platelet counts, inflammatory markers, and H score [28].