A Clinical Update on Employing Tocilizumab to Fight COVID-19

*Nilanjana Dhara, Sumana Saha and Saptarshi Chatterjee*

### **Abstract**

SARS-CoV-2 infection or COVID-19, currently regarded as 'terror' worldwide, has spread uncontrollably as a serious menace. Till date, limited effective medicines or treatments are available. The mortality and morbidity rates have increased considerably, which have been aggravated by acute respiratory distress syndrome (ARDS) and new and old cardiovascular injuries. To control COVID-19, many drugs have been taken into consideration, like ACE2 blockers, anti-inflammatory drugs, antibodies against IL-1 and anti-IL-6, Remdesivir, Dexamethasone, Hydroxychloroquine and vaccines. In this chapter, preference is given to Tocilizumab with the latest status of clinical research update available. Despite several clinical research attempts, some have yielded promising results, others are inconclusive.

**Keywords:** COVID-19, Tocilizumab, Clinical Studies, Antiviral drugs, Public Health

#### **1. Introduction**

Since December 2019, the outbreak of the novel coronavirus (SARS-CoV-2) infection (i.e. COVID-19), from Wuhan, China as a pandemic, has posed a serious threat towards mankind, treatment of which is still unknown [1]. In Jan 30, 2020, the novel coronavirus disease 2019 (COVID-19), was declared as the Sixth public health emergency epidemic by the World Health Organization [WHO] [2]. Till date there is no single drug to control it. Despite Remdesivir being used extensively for the treatment, it is still under clinical trials [3] and not beyond question [4]. The elderly, immune-compromised or people having co-morbidities led to acute respiratory distress syndrome (ARDS), cardiovascular (CV) complications, and multi-organ failure [2, 5]. Common symptoms of the disease include fever, cough, myalgia, malaise, breathlessness and diarrhea [2]. Tocilizumab (a humanized anti-IL-6 receptor antibody) is one of drugs used for the treatment of COVID-19 hospitalized patients [6]. This article summarizes all critical clinical trials to evaluate the efficacy of Tocilizumab.

#### **2. About the molecule**

Tocilizumab is an Interleukin-6 Receptor Inhibitor, having a molecular formula of [C6428H9976N1720O2018S42]. Its molecular mass is of [145.0 kDa], CAS number: [375823-41-9]. It is a recombinant humanized monoclonal antibody used in the treatment of inflammatory and autoimmune conditions like Rheumatoid arthritis, multiple myeloma and prostate cancer, nowadays used extensively for COVID-19 treatment [7–11].
