As of October 2020 management of Coronavirus disease 2019 (COVID-19) is based on supportive care and off-label or compassionate-use therapies. On March 2020 tocilizumab - an anti-IL-6 receptor monoclonal antibody - was suggested as immunomodulatory treatment in severe COVID-19 because hyperinflammatory syndrome occurs in many patients similarly to the cytokine release syndrome that develops after CAR-T cell therapy. In our retrospective observational study, 20 severe COVID-19 patients requiring intensive care were treated with tocilizumab in addition to standard-of-care therapy (SOC) and compared with 13 COVID-19 patients receiving only SOC. Clinical respiratory status, inflammatory markers and vascular radiologic score improved after one week from tocilizumab administration. On the contrary, these parameters were stable or worsened in patients receiving only SOC. Despite major study limitations, improvement of alveolar-arterial oxygen gradient as well as vascular radiologic score after one week may account for improved pulmonary vascular perfusion and could explain the more rapid recovery of COVID-19 patients receiving tocilizumab compared to controls.

截至 2020 年 10 月，2019 年冠状病毒病 (COVID-19) 的治疗基于支持性护理和标签外或同情使用疗法。2020 年 3 月，托珠单抗（一种抗 IL-6 受体单克隆抗体）被建议作为重症 COVID-19 的免疫调节治疗，因为许多患者会出现与 CAR-T 细胞治疗后出现的细胞因子释放综合征类似的高炎症综合征。在我们的回顾性观察研究中，20 名需要重症监护的重症 COVID-19 患者在标准护理治疗 (SOC) 的基础上接受了托珠单抗治疗，并与 13 名仅接受 SOC 的 COVID-19 患者进行了比较。托珠单抗给药一周后，临床呼吸状况、炎症标志物和血管放射学评分有所改善。相反，在仅接受 SOC 的患者中，这些参数稳定或恶化。尽管研究存在重大局限性，但一周后肺泡动脉氧梯度以及血管放射学评分的改善可能是肺血管灌注改善的原因，并且可以解释接受托珠单抗治疗的 COVID-19 患者与对照组相比恢复得更快。