ID consultation is needed for the use of tocilizumab for Covid-19
Tocilizumab is not recommended for the majority of pediatric patients who have mild or moderate COVID-19. For children with severe or critical illness, use of tocilizumab should be evaluated on a case-by-case basis in consultation with the Pediatric Infectious Diseases team
Recent data have suggested that tocilizumab in conjunction with dexamethasone can result in a reduction in days of organ support and mortality if used within 24 hours of receiving organ support
Use of tocilizumab can be considered in combination with dexamethasone in certain hospitalized patients who are exhibiting rapid respiratory decompensation due to COVID-19 meeting the following inclusion/exclusion criteria:
Admitted to ICU < 24 hours and:
OR
Recently hospitalized patients (not in an ICU) with:
Without high suspicion of bacterial/fungal/mycobacterial infection
Tocilizumab single intravenous dose of 8 mg/kg TBW/Adj BW (obese) (Max: 800 mg)
In setting of extreme shortage: Sarilumab 400mg x 1 dose may be used in lieu of tocilizumab
Potential Therapeutic Agents