Compassionate Use of Tocilizumab in Severe SARS-CoV2 Pneumonia. When late administration is too late

https://doi.org/10.1101/2020.06.13.20130088

In a compassionate-use basis to patients with SSP hospitalized (excluding intensive care and intubated cases) who required oxygen support to have a saturation >93%. Primary endpoint was intubation or death after 24
hours of its administration. A total of 207 patients were studied and 186 analysed. The mean age was 65 years and 68% were male. A co-existing condition was present in 68 % of cases. At baseline, 114 (61%) required oxygen support with FiO2 >0.5 % and 72 (39%) ≤0.5%. Early administration of tocilizumab, when the need of oxygen support was still below FiO2
≤0.5%, was significantly more effective than given it in advanced stages (FiO2 >0.5 %), achieving lower rates of intubation or death (13% vs 37% repectively, p<0·001). The benefit of tocilizumab in severe SARS-Cov-2 pneumonia is only expected when it is administrated before the need of high oxygen support.