Background In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov ( NCT04381936 ). Findings Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research.

Highlights About two thirds of caregivers intend to vaccinate their children against COVID-19. Most common reason for acceptance was to protect the child. Most common reason for refusal was the vaccine’s novelty. Child age, chronic illness, vaccination history affects willingness. Caregiver gender, vaccination history, concern about infection affect willingness.

The economic and psychosocial consequences of the COVID-19 pandemic have been far-reaching and unprecedented around the world. These circumstances appear to have had profound psychological effects on all individuals worldwide. One psychological aspect of the COVID-19 pandemic is fear. This brief paper argues that assessing fear is important and is the key reason we co-developed the 'Fear of COVID-19 Scale' (FCV-19S). It is argued that without knowing the level of fear about COVID-19 among different groups by specific socio-demographic variables (e.g., gender, age, education, ethnicity, religiosity, etc.) and/or different psychological factors (e.g., personality type) it is difficult to know whether education and prevention programs are needed, and if they are needed which groups to target and where. The collation and application of such data could be used to devise targeted education and/or prevention programs to help overcome fear of COVID-19 and help such individuals to engage in preventative behaviors.

No abstract

No abstract