Study to Evaluate the Efficacy and Safety of Tocilizumab Versus Corticosteroids in Hospitalised COVID-19 Patients With High Risk of Progression
COVID-19
About this trial
This is an interventional treatment trial for COVID-19 focused on measuring COVID-19
Eligibility Criteria
Inclusion Criteria:
1) Hospitalised symptomatic COVID-19 patients 2( Presence of clinical and radiological signs of progressive disease, AND laboratory evidence indicative of risk for cytokine storm complications.
All patients participating in this clinical trial must meet the following inclusion criteria:
- Hospitalised symptomatic COVID-19 patients
Presence of clinical and radiological signs of progressive disease, AND laboratory evidence indicative of risk for cytokine storm complications:
Clinical:
Dyspnoea OR RR>20 breaths/min AND O2 sat <93% on RA OR increasing need for O2 supplementation to maintain O2 sat >95% on RA
WITH
Radiological:
CXR or CT indicative of pneumonia OR worsening findings over time
AND
Laboratory:
CRP levels >60 OR an increase of CRP >20 over 12 hours WITH an increasing ferritin level OR declining lymphocyte counts
- Age > 18 years and able to give consent
Exclusion Criteria:
Patients will be excluded if any of the following conditions apply:
- Known sensitivity/allergy to TCZ or other monoclonal antibodies
- AST/ALT>5 times UNL, platelet counts <50,000 or neutrophil counts <500
- Active TB
- Pregnant
- Receipt of mechanical ventilation
- Has received other immunomodulatory drugs (including TCZ) in the past for the treatment of other conditions
- Individuals, in the opinion of the investigator, where progression to death is imminent and inevitable in the next 24 hours irrespective of treatment provision or who have signed a DNR.
- Participating in other clinical trials (subject to approval)
- Any serious medical condition or abnormal clinical laboratory tests which in the judgement of the investigator may compromise patient safety should he/she participate in the study.
Sites / Locations
- University Malaya Medical Centre
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Tocilizumab
Methylprednisolone
Tocilizumab is given at 8 mg/kg (body weight) once and administered as an intravenous infusion within no less than 60 minutes.
Reconstituted methylprednisolone is infused over 30 minutes and administered at a dose of 120mg/day for 3 days