key: cord-0919270-ej9guh4d
authors: Kow, Chia Siang; Hasan, Syed Shahzad
title: Interleukin-6 blockade with tocilizumab in COVID-19: Does it live up to its hype?
date: 2020-10-21
journal: Pulmonology
DOI: 10.1016/j.pulmoe.2020.10.004
sha: a161153617888a8db3d36e126ecc6530452470c2
doc_id: 919270
cord_uid: ej9guh4d

nan

between patients who received tocilizumab and patients who received a placebo (10.4% and 8.6%, respectively).

The findings from randomized controlled trials have proved that the use of tocilizumab in COVID-19 did not live up to the hype, where the increased concentration of IL-6 does not imply that its neutralization will be effective in COVID-19.. There is a possibility that the wrong cytokine was targeted to dampen the cytokine storm in COVID-19. A recent prospective study by Blot et al. 5 compared the concentrations of IL-6 between 27 patients with COVID-19 pneumonia and 36 patients with non-COVID-19 pneumonia. It was reported that the plasma concentrations of IL-6 were significantly lower in the patients with COVID-19 pneumonia compared to the patients with pneumonia other than COVID-19 (121.0 pg/mL versus 460.4 pg/mL).

The findings of this prospective study, coupled with the findings from two randomized controlled trials that failed to detect mortality benefits with tocilizumab, suggest that IL-6 may not be the cytokine that drives the progression of COVID-19. The use of tocilizumab is not harmless since it may predispose patients to the development of secondary infections. We suggest a shift in focus and to target other mediators of hyperinflammatory state in COVID-19.

J o u r n a l P r e -p r o o f

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Is Interleukin 6 the Right Target in COVID-19 Severe Pneumonia?