A cohort study of 778 patients with COVID-19 in a hyperinflammatory state was conducted to investigate the effect of treatment with tocilizumab and corticosteroids on intubation and death. The patients were categorized into the following exposure groups: tocilizumab treatment, treatment with pulse dose of corticosteroids (PDC), treatment with intermediate-high dose of corticosteroids (IHDC), combination therapy of both corticosteroids and tocilizumab, and no treatment.

• 11.4% of 88 patients treated with tocilizumab were either intubated or died.

• 23.1% of 117 patients who received IHDC were either intubated or died.

• 15.4% of 78 patients who received PDC were either intubated or died.

• 25.6% of 151 patients who received combination therapy were either intubated or died.

• 21.1% of 344 patients who did not receive treatment were either intubated or died.

• Treatment with tocilizumab alone was associated with a reduced hazard of death and intubation.

• Treatment with PDC appeared to be associated with a reduced risk of death, but the results were not consistent.

• No significant association was detected between IHDC treatment or combination therapy and death/intubation.