Efficacy of tocilizumab in the intensive care unit patients with COVID-19: a retrospective cohort study

Download in PDF


To evaluate the efficacy of earlier and late tocilizumab (TCZ) infusion, that is, prior to and after initiation of mechanical ventilation, in reducing mortality in a cohort of patients with severe COVID-19 pneumonia who required support in the intensive care unit (ICU).

Material and methods

We conducted a retrospective cohort study in patients with severe COVID-19 pneumonia who were admitted to the ICUs across Russia between March 16 and May 5, 2020, for worsening oxygenation. All patients were treated with the standard of care, and a subset of patients also received intravenous TCZ. The primary endpoint of in-hospital all-cause mortality was compared between patients who received TCZ and those who did not using logistic regression model after adjustment for age and gender.


159 of 328 patients (57.0% males, median age of 59 years) received at least one 400 mg flat dosing of TCZ. TCZ was administered to 83 (60.1%) of 137 patients who needed oxygen therapy or noninvasive ventilation (earlier TCZ cohort), and to 76 (39.8%) of 191 intubated patients (late TCZ cohort). Neither earlier nor late TCZ administration resulted in a lower risk of death compared to patients who did not receive TCZ infusion (age and gender adjusted odds ratios were 2.370, 95% CI 0.969-5,798; р=0.059, and 0.996, 95% CI 0.539-1.839; р=0.989, respectively).

Key words

COVID-19, pneumonia, ICU, tocilizumab, mortality.