A Comprehensive Review of Tocilizumab in COVID-19 Acute Respiratory Distress Syndrome

J Clin Pharmacol. 2020 Sep;60(9):1131-1146. doi: 10.1002/jcph.1693. Epub 2020 Jul 27.


Currently, the world is facing the pandemic of a novel strain of beta-coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Acute respiratory distress syndrome (ARDS) is the most devastating complication of SARS-CoV-2. It was indicated that cytokine-release syndrome and dominantly interleukin (IL)-6 play a central role in the pathophysiology of ARDS related to the novel 2019 coronavirus disease (COVID-19). Despite the global emergency of the disease, at this time, there are no proven therapies for the management of the disease. Tocilizumab is a potential recombinant monoclonal antibody against IL-6 and currently is under investigation for the management of ARDS in patients with COVID-19. Given these points, we reviewed the current evidence regarding the potential therapeutic role of tocilizumab and its important clinical issues in the treatment of ARDS related to COVID-19.

Keywords: ARDS; COVID-19; CRS; IL-6; SARS-CoV-2; acute lung injury; tocilizumab.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Antibodies, Monoclonal, Humanized / pharmacology
  • COVID-19 / complications
  • COVID-19 Drug Treatment*
  • Cytokine Release Syndrome / drug therapy
  • Cytokine Release Syndrome / virology
  • Humans
  • Interleukin-6 / immunology
  • Respiratory Distress Syndrome / drug therapy*
  • Respiratory Distress Syndrome / virology


  • Antibodies, Monoclonal, Humanized
  • Interleukin-6
  • tocilizumab