2021年 · 第101卷第10期

Currently, there is a lack of effective therapeutic drugs for the treatment of novel coronavirus pneumonia (COVID-19). The convalescent plasma (CP) of COVID-19 recovered patients contains neutralizing antibodies against COVID-19 and has been approved for the treatment of COVID-19 in many countries, but its efficacy still lacks the validation of large-scale randomized controlled trial (RCT) studies. A recent randomized double-blind controlled study confirmed that high-titer convalescent plasma therapy can reduce the risk of developing severe illness in elderly COVID-19 patients.

The inflammatory storm plays an important role in the pathogenesis of severe and critical novel coronavirus pneumonia (hereinafter referred to as COVID-19). Studies confirm that interleukin-6 (IL-6) can be used as a biomarker to warn of inflammatory storms in COVID-19 patients, and that elevated IL-6 levels are associated with poor prognosis in COVID-19. tocilizumab, an IL-6 receptor antagonist, has been used in the treatment of many autoinflammatory diseases such as rheumatoid arthritis. In order to evaluate the efficacy and safety of tocilizumab in the treatment of COVID-19, Mount Sinai Hospital and other hospitals in the United States jointly conducted a global multicenter phase 3 clinical trial. Enrollment criteria were: confirmed cases of COVID-19 hospitalized and aged ≥18 years; Patients who had received either non-invasive positive pressure ventilation or invasive mechanical ventilation were excluded. The study randomized (in a 2:1 ratio) hospitalized patients with COVID-19 who did not receive mechanical ventilation to receive one or two doses of tocilizumab (dose: 8 mg/kg) or placebo, with clinical outcomes including mechanical ventilation and death within 28 days.