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00925njm 22002777a 4500 dc Ruiz-Antorán, Belén author Sancho-López, Aránzazu author Torres, Ferrán author Moreno-Torres, Víctor author de Pablo-López, Itziar author García-López, Paulina author Abad-Santos, Francisco author Rosso-Fernández, Clara M author Aldea-Perona, Ana author Montané, Eva author Aparicio-Hernández, Ruth M author Llop-Rius, Roser author Pedrós, Consuelo author Gijón, Paloma author Hernández-Carballo, Carolina author Pedrosa-Martínez, María J author Rodríguez-Jiménez, Consuelo author Prada-Ramallal, Guillermo author Cabrera-García, Lourdes author Aguilar-García, Josefa A author Sanjuan-Jimenez, Rocío author Ortiz-Barraza, Evelyn I author Sánchez-Chica, Enrique author Fernández-Cruz, Ana author TOCICOV-study group author 2020-12-06 We 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. 10.1007/s40121-020-00373-8 2193-8229 Infectious diseases and therapy http://hdl.handle.net/10668/16742 33280066 http://hdl.handle.net/20.500.12105/18170 COVID-19 Mortality SARS-CoV-2 Steroids Tocilizumab Combination of Tocilizumab and Steroids to Improve Mortality in Patients with Severe COVID-19 Infection: A Spanish, Multicenter, Cohort Study.