"TCZ was administered at a dosage of 8 mg/kg (max 800 mg) by two
consecutive intravenous infusions 12 h apart. A third infusion, 24 h
apart from the second was optional based on clinical response."

University of Michigan - Ann Arbor

- Population selection
- Brescia COVID-19 Respiratory Severity Scale (BCRSS)
- Other concurrent therapies
- TCZ dosage

Methods for tracking outcomes among 100 severe COVID-19 patients in Brescia, Italy  24–72 h after Tocilizumab (TCZ) infusion

Toniati P, Piva S, Cattalini M, et al. Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy. Autoimmun Rev. 2020;19(7):102568. 

doi:10.1016/j.autrev.2020.102568

Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy

- "9-category ordinal severity scale ranging from
0 (asymptomatic patient) to 8 (a critically ill patient with tracheal intubation, mechanical ventilation and advanced ICU management"

- "The BCRSS has been developed through multiple interactions
by a multidisciplinary team of intensive care physicians, infectious
disease specialists, pneumologists, internists, rheumatologists and immunologists to rapidly assess the patients' respiratory condition. BCRSS
classifies the patients' severity based on the need for oxygen supplementation and ventilatory support, offering a step-up therapeutic approach for the use of antiviral and anti-inflammatory drugs. The scale
was rapidly adopted at a regional level and used to define pragmatically
the patient's response to treatment "

Brescia COVID-19 Respiratory Severity Scale (BCRSS)

All patients recieved standard treatment during the study.
- Medications:
  - antiviral drugs lopinavir 400mg and ritonavir 100 mg 2x/day or remdesivir 100 
mg/day
  - antibiotic prophylaxis (azithromycin, ceftriaxone or piperacillin/tazobactam)
  - hydroxychloroquine 400 mg/day
  - dexamethasone 20 mg/
day
 
- Ventilation (non-invasive or tracheal intubation as needed)


Other concurrent therapies in evaluating outcomes among 100 severe COVID-19 patients in Brescia, Italy after Tocilizumab (TCZ) infusion 

- 100 patients admitted to Spedali Civili of Brescia, a 1570-bed university hospital in Brescia, Italy in the hard-hit Lombardy region
- Requirements
   - Hospitalized between March 9-20
   - Diagnosis with COVID-19 pneumonia
   - Disease assessed as "severe" according to BCRSS
   - No contraindications for TCZ use



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