Severe COVID-19 was connected with an immune response imbalance. Researchers expected that interleukin-6 blocking would be beneficial for patients with increased inflammation, as indicated by elevated levels of certain biomarkers of inflammation. Patients hospitalized with COVID-19, hypoxemia, and at least 2 of 4 significantly elevated inflammatory markers (interleukin-6, C-reactive protein, ferritin, and D-dimer) were randomized to receive tocilizumab (TCZ) in addition to standard of care (SoC) or SoC alone. The primary outcome was the clinical state at day 28 on a 7-category ordinal scale; supplementary goals were intensive care unit hospitalization, breathing support, and length of hospital admission. On day 28, the clinical condition of patients who got TCZ in addition to SoC was significantly superior to that of individuals who received SoC alone (P=0.037). About 93% of patients who got TCZ (n=53 of 57) and 86% of patients in the control group (n=25 of 29) were discharged from the hospital. Moreover, 47% of TCZ patients (n=27 of 57) and 24% of control patients (n=7 of 29) had resumed normal daily activities. The median period of hospitalization in the TCZ group was 9 days (range, 7–12) compared to 12 days (range, 9–15) in the control group (P=0.014). In patients hospitalized with COVID-19, hypoxemia, and increased inflammatory markers, therapy of TCZ in addition to SoC was linked with significantly improved clinical recovery by day 28 and a shorter hospital stay than administration of SoC alone.