Although the starting event in COVID-19 is a viral infection some patients present with an over-exuberant inflammatory response, leading to acute lung injury (ALI) and adult respiratory distress syndrome (ARDS). Since IL-6 plays a critical role in the inflammatory response, we assessed the efficacy and safety of tocilizumab (TCZ) in this single-centre, observational study in all Covid-19 in-patient with a proven SARS-CoV-2 rapidly progressing infection to prevent ALI and ARDS. 104 patients with COVID-19 treated with TCZ had a lower mortality rate (5·8%) compared with the regional mortality rate (11%), hospitalized patient's mortality (10%), and slightly lower than hospitalized patients treated with our standard of care alone (6%). We found that TCZ rapidly decreased acute phase reactants, ferritin and liver release of proteins. D-Dimer decreased slowly. We did not observe specific safety concerns. Early administration of IL6-R antagonists in COVID-19 patients with impending hyperinflammatory response, may be safe and effective treatment to prevent, ICU admission and further complications.

尽管 COVID-19 的起始事件是病毒感染，但一些患者出现过度旺盛的炎症反应，导致急性肺损伤 (ALI) 和成人呼吸窘迫综合征 (ARDS)。由于 IL-6 在炎症反应中起着关键作用，我们在这项单中心、观察性研究中评估了托珠单抗 (TCZ) 的有效性和安全性，该研究针对所有 Covid-19 住院患者，该患者经证实 SARS-CoV-2 进展迅速感染以预防 ALI 和 ARDS。104 名接受 TCZ 治疗的 COVID-19 患者的死亡率（5·8%）低于区域死亡率（11%）、住院患者死亡率（10%），略低于接受我们标准治疗的住院患者单独护理（6%）。我们发现 TCZ 迅速减少急性期反应物、铁蛋白和肝脏蛋白质释放。D-二聚体下降缓慢。我们没有观察到具体的安全问题。在即将发生高炎症反应的 COVID-19 患者中早期使用 IL6-R 拮抗剂可能是安全有效的治疗方法，可以预防、ICU 入住和进一步的并发症。