Safety and Efficacy of Tocilizumab in Moderate to Severe COVID-19 With Inflammatory Markers

Inclusion Criteria: * Male and females with 18 years and older * Confirmed diagnosis of SARS-CoV 2 infection * More than 3 days of symptoms related to COVID-19 * Computed tomography (or Chest X-Ray) with COVID-19 alterations * Both of the criteria 1. Need for oxygen supplementation to keep SPO2 \> 93% OR need for mechanical ventilation for less than 24 hours before the randomization 2. At least two of the following inflammatory tests above the cutoff : 1. D-dimer \> 1,000 ng/mL 2. Reactive C protein \> 5 mg/dL 3. Ferritin \> 300 mg/dL 4. Lactate dehydrogenase \> upper level limit Exclusion Criteria: * Need for mechanical ventilation for 24 hours or more before the randomization * Hypersensitivity to tocilizumab * Patients without therapeutic perspective or in palliative care * Active non controlled infections * Other clinical conditions that contraindicate tocilizumab, according to the assistant physician * Low neutrophils count (\< 0.5 x 109/L) * Low platelets count (\< 50 x 109/L) * Liver disease, cirrhosis or elevated AST or ALT above 5 times the upper level limit * Renal disease with estimate glomerular filtration below 30 mL/min/1.72 m2 (MDRD or CKD-EPI scores) * Active diverticulitis * Breastfeeding women * Pregnancy