A 56-year-old woman is hospitalised on day 9 of COVID-19 with bilateral ground-glass opacities, respiratory rate 28/min, SpO2 91% on 4 L/min supplemental oxygen, and C-reactive protein of 118 mg/L. She has received a full course of corticosteroids. Which add-on intervention has been shown to improve outcomes in this setting?
- A Interferon alfa inhalation
- B Hydroxychloroquine plus azithromycin
- C Tocilizumab, an interleukin-6 receptor antagonist ✓
- D Prophylactic therapeutic plasma exchange
Correct answer: C. Tocilizumab, an interleukin-6 receptor antagonist
Explanation
Hospitalised patients with severe COVID-19 requiring supplemental oxygen who show markers of systemic inflammation, classically a markedly raised CRP, benefit from interleukin-6 receptor blockade with tocilizumab, which reduces progression to mechanical ventilation and mortality in randomised trials. Hydroxychloroquine was conclusively shown ineffective and harmful in rhythm terms, eliminating option B. Interferon alfa has value only early in mild disease, not in the hyperinflammatory phase.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.