Ruiz-Antorán, BelénSancho-López, AránzazuTorres, FerránMoreno-Torres, Víctorde Pablo-López, ItziarGarcía-López, PaulinaAbad-Santos, FranciscoRosso-Fernández, Clara MAldea-Perona, AnaMontané, EvaAparicio-Hernández, Ruth MLlop-Rius, RoserPedrós, ConsueloGijón, PalomaHernández-Carballo, CarolinaPedrosa-Martínez, María JRodríguez-Jiménez, ConsueloPrada-Ramallal, GuillermoCabrera-García, LourdesAguilar-García, Josefa ASanjuan-Jimenez, RocíoOrtiz-Barraza, Evelyn ISánchez-Chica, EnriqueFernández-Cruz, AnaTOCICOV-study group2025-01-072025-01-072020-12-062193-8229https://hdl.handle.net/10668/26780We aimed to determine the impact of tocilizumab use on severe COVID-19 (coronavirus disease 19) pneumonia mortality. We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocilizumab were compared to patients not treated with tocilizumab, adjusting by inverse probability of the treatment weights (IPTW). Tocilizumab's effect in patients receiving steroids during the 48 h following inclusion was analysed. During the study period, 506 patients with severe COVID-19 fulfilled the inclusion criteria. Among them, 268 were treated with tocilizumab and 238 patients were not. Median time to tocilizumab treatment from onset of symptoms was 11 days [interquartile range (IQR) 8-14]. Global mortality was 23.7%. Mortality was lower in patients treated with tocilizumab than in controls: 16.8% versus 31.5%, hazard ratio (HR) 0.514 [95% confidence interval (95% CI) 0.355-0.744], p  These results show that survival of patients with severe COVID-19 is higher in those treated with tocilizumab than in those not treated and that tocilizumab's effect adds to that of steroids administered to non-intubated patients with COVID-19 during the first 48 h of presenting with respiratory failure despite oxygen therapy. Randomised controlled studies are needed to confirm these results. European Union electronic Register of Post-Authorization Studies (EU PAS Register) identifier, EUPAS34415.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/COVID-19MortalitySARS-CoV-2SteroidsTocilizumabresearch article33280066open access10.1007/s40121-020-00373-8PMC7719057https://link.springer.com/content/pdf/10.1007/s40121-020-00373-8.pdfhttps://pmc.ncbi.nlm.nih.gov/articles/PMC7719057/pdf