Glucocorticoids alone versus tocilizumab alone or glucocorticoids plust ocilizumab in patients with severe SARS-CoV-2 pneumonia and mild inflammation

Aim: To assess clinical outcomes according to the immunosuppressive treatment administered to patientswith severe SARS-CoV-2 pneumonia and moderate inflammation. Methods: A retrospective observational cohort study involving 142 patients with severe COVID-19 pneumonia and moderate inflammation divided into three treatment groups (pulses of methylprednisolonealone [group I], tocilizumab alone [group II] and methylprednisolone plus tocilizumab [group III]). Theaim was to assess intergroups differences in the clinical course with a 60-day follow-up and relatedanalytical factors.Results: 14 patients (9,8%) died: 8 (10%) in group I and 6 (9,5%) in groups II and III. 15 (10,6%) were admittedto ICU: 2 (2,5%) from group I, 4 (28,5%) from group II and 9 (18,4%) from group III. The mean hospital staywas longer in group II and clinical outcome was not associated with treatment. Conclusions: Tocilizumab seems to be not associated with better clinical outcomes and should be reservedfor clinical trial scenario, since its widespread use may result in higher rate of ICU admission and longermean hospital stay without differences in mortality rate and potentially adverse events. (C) 2021 Elsevier Espana, S.L.U. All rights reserved.