| Introduction: The coronavirus disease 2019 (COVID-19) pandemic, caused by a newly discovered
coronavirus (severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2), continues to spread all
around the world. Despite the emergency of COVID-19 worldwide, remdesivir is the only treatment that
has been recently approved to treat the diseases, and other effective therapies are still lacking. SARSCoV-2 may cause severe illness in 20% of patients. Based on available data, there is an association
between interleukin-6 (IL-6) and severe COVID-19. Sarilumab is a fully human immunoglobulin G1
monoclonal antibody binding to both membrane-bound and soluble IL-6 receptors with high affinity
and has been considered for off-label use in the treatment of COVID-19.
Areas covered: The present article reviews recently published literature focusing on the pathophysiology of COVID-19 induced cytokine storm, the potential therapeutic role, and important clinical issues of
sarilumab in the treatment of COVID-19 patients.
Expert opinion: The off-label treatment administration is unavoidable in the critical situation of the
COVID-19 pandemic. Further efforts should be directed to determine mechanisms of SARS-CoV-2
induced immune dysregulation as well as indications of sarilumab in the patients with COVID-19 to
minimize concerns regarding its off-label administration |