The following is a summary of “Efficacy of tocilizumab for hospitalized patients with COVID-19 pneumonia and high IL-6 levels: A randomized controlled trial,” published in the April 2025 issue of Infection by Sellarès-Nadal et al. 

Researchers conducted a retrospective study to assess the efficacy and safety of an IL-6-driven personalized treatment strategy using tocilizumab in individuals with severe COVID-19 pneumonia.  

They randomized 1:1 adult patient with severe COVID-19 pneumonia and IL-6 serum levels >40 pg/mL to receive either standard of care (SOC) or SOC plus 1 dose of tocilizumab while the primary output was death or need for invasive mechanical ventilation (IMV) within 28 days. Secondary outcomes included ICU admission, IMV duration, and hospital stay. A meta-analysis was executed to estimate the impact of tocilizumab on mortality and IMV requirement in COVID-19 pneumonia.  

The results showed that 62 patients were included, with 30 in the SOC arm and 32 in the standard-treatment plus tocilizumab arm. The primary outcome emerged in 12.9% of the tocilizumab group and 32.3% of the SOC group (P = 0.068). A trend was observed towards fewer days on IMV in the tocilizumab group (7.5 vs 19.5 days, P = 0.073) and a shorter hospital stay (4 vs 8 days, P = 0.134) with no serious adverse events, and the meta-analysis showed RR for death or IMV of 0.83 (95% CI: 0.77–0.89) in the tocilizumab group compared to the SOC group.  

Investigators concluded that tocilizumab potentially reduced mortality or the need for IMV in patients with severe COVID-19 pneumonia and elevated IL-6 serum levels, and its safety profile in this patient group did not raise significant concerns. 

Source: link.springer.com/article/10.1007/s15010-025-02506-y