Tocilizumab in severe COVID-19: A promise fulfilled

Platelet-leukocyte crosstalk in COVID-19: How might the reciprocal links between thrombotic events and inflammatory state affect treatment strategies and disease prognosis?

“…However, due to the risk of thromboembolisms [237] and generalized immune suppression, their high dose and long prescription especially in critically ill patients are almost challenging therapeutic approaches [238]. Some earlier retrospective cohort studies have suggested tocilizumab (a monoclonal anti-soluble IL-6 receptor antibody) as an efficient treatment for COVID-19 [239]. Given these preliminary findings, in a larger randomised controlled trials (REMAP/CAP-RE-COVERY trial platform) adding tocilizumab to standard dexamethasone treatment showed superior effect in patients treatment compared to dexamethasone alone [240] with increasing organ support-free days as well as a 1.6-fold increment in chance of survival compared to control.…”

Use of Tocilizumab in hospitalized patients during the first wave of the COVID-19 pandemic

“…No differences were found in D-dimer and ferritin as observed by other authors. (8,12,13) Tocilizumab was well-tolerated, and, from a safety point of view, the adverse effects observed (neutropenia and hepatotoxicity) were transient. Similar results were obtained by Duarte et al (7) in a cohort of elderly patients in our country.…”

Anticoagulation as secondary prevention of massive lung thromboses in hospitalized patients with COVID-19

“…Therefore, monoclonal antibodies targeting pro-inflammatory mediators have been proposed for the treatment of COVID-19 induced microvasculature injury and endothelial damage leading to thrombotic microangiopathy (TMA)[ 7 , 8 ]. Tocilizumab, an interleukin-6 inhibitor (IL-6), may reduce endothelial inflammation, microvascular thrombosis, and mortality[ 33 , 34 , 35 ].…”