Comparing oxygen demand in critical covid-19 patients using single versus double doses of tocilizumab

Saudi Med J. 2023 May;44(5):513-517. doi: 10.15537/smj.2023.44.5.20220755.


Objectives: To compare the outcomes of single versus double doses of tocilizumab in patients with severe COVID-19, especially on different types of oxygenation requirements.

Methods: This cross-sectional study was carried out from January 2020 to March 2020. Patients diagnosed with COVID-19, who received at least one dose of tocilizumab, were included. The dependent variable was tocilizumab dose (single versus double). The primary outcome variable was oxygen demand on the first and last day of hospitalization. A series of comparisons between patients administered one dose of tocilizumab versus 2 doses were conducted.

Results: Herein, 80 patients with severe COVID-19 infection were included, of whom 68.8% received one dose of tocilizumab, while 31.3% received a double dose. Two-thirds of the patients were male, with an overall average age of 58 years. In patients receiving 2 doses, oxygen demand tended to worsen by the seventh day, while in those who received one dose. The group that received 2 doses had a longer length of hospital stay.

Conclusion: This study could not capture the additional value of the second dose for different health outcomes. However, the results can inform clinician from experience when facing uncertainty due to new virus or variant.

Keywords: COVID-19; Saudi Arabia; antiviral; double dose; oxygen demand; tocilizumab.

MeSH terms

  • COVID-19 Drug Treatment
  • COVID-19*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oxygen
  • SARS-CoV-2
  • Treatment Outcome


  • tocilizumab
  • Oxygen