tocilizumab failed to reduce mortality in severe covid-19 patients: results from a randomized controlled clinical trial

The severe coronavirus disease 2019 (covid-19) is associated with increased levels of blood interleukin (il)-6. therefore, it is hypothesized that modulating the levels or effects of il-6 could diminish airway inflammation and alter the course of covid-19.we conducted a controlled, randomized, double-blind clinical trial on hospitalized patients with severe covid-19 in iran. the patients were randomly distributed by block randomization to take either standard-of-care (soc) plus 1 or 2 doses of tocilizumab 8 mg/kg or soc alone. the endpoint was defined by clinical improvement and discharge.we enrolled 40 patients (20 patients in each group) from 10 july to 10 december 2020. after randomization, 1 patient in the soc arm and 3 patients in the tocilizumab arm refused to participate and were eliminated from the study.the mean age of participants was 59.62±15.80 in the tocilizumab group (8 women and 9 men)and 63.52±12.83 years old in the soc group (9 women and 10 men) groups. the number of patients who recovered did not differ significantly between the tocilizumab and soc groups (12 [70.6%][70.6%] vs. 15 [78.9%]), respectively). hospitalization rates were also similar between the groups (log-rank test, p=0.615; hazard ratio, 0.83; 95% ci [0.39–1.78]). the results show that tocilizumab could not be a beneficial agent for treating severe cases of covid-19 patients and would not significantly improve clinical outcomes.