Mariette X, Hermine O, Tharaux PL, et al. - For treating patients with moderate-to-severe COVID-19–associated pneumonia and high CRP levels, consideration may be given to tocilizumab.

• In this article, researchers reported extended follow-up data to 90 days of their previously published trial of tocilizumab in hospitalized patients who were receiving oxygen (rate, ≥ 3 L/min) but did not require high-flow or mechanical ventilation.

• The primary composite endpoint of the study was met, which was the proportion of patients who necessitated noninvasive ventilation or intubation or who died at day 14, but suggested no survival difference at day 28.

• By day 90, seven of 63 (11%) and 11 of 67 patients (18%) died in the tocilizumab and usual care arms, respectively.

• A statistical interaction was observed between CRP levels and the primary composite endpoint at day 14 and survival at day 90, with tocilizumab as beneficial in patients with CRP levels greater than 15.0 mg/dL (to convert to mg/L, multiply by 10), but not in those with CRP levels 15.0 mg/dL or less.

• In the tocilizumab and usual care groups, the chance of achieving the primary end point (the percentage of patients who received noninvasive or invasive ventilation or those who died) among patients with CRP levels greater than 15.0 mg/dL was 18% and 57%, respectively, .

• Similarly, the groups had day-90 mortality of 9% and 35%, respectively.