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Response to: ‘Correspondence on ‘Historically controlled comparison of glucocorticoids with or without tocilizumab versus supportive care only in patients with COVID-19-associated cytokine storm syndrome: results of the CHIC study’’ by Kaklamanos et al
  1. Sofia Ramiro1,2,
  2. Rémy L M Mostard3,
  3. Robert B M Landewé1,4
  1. 1Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands
  2. 2Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  3. 3Department of Pulmonology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
  4. 4Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands
  1. Correspondence to Dr Sofia Ramiro, Department of Rheumatology, Zuyderland Medical Center, 6419 PC Heerlen, Limburg, The Netherlands; sofiaramiro{at}

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We have read with interest the letter by Kaklamanos et al1 pertaining to our COVID-19 High-intensity Immunosuppression in Cytokine storm syndrome (CHIC) study.2 Kaklamanos et al share their positive experience with tocilizumab administered to three patients with severe COVID-19 pneumonia, accompanied by signs of hyperinflammation, as described in our CHIC study.1 These descriptions perfectly match with our clinical experience regarding the use of tocilizumab in such critically ill patients and mirror the patients we have described in our CHIC study.2 Fortunately, the benefits of tocilizumab in such patients have meanwhile also been confirmed in randomised controlled trials, which hopefully paves the way, although with significant delay, for a more widespread use in COVID-19 patients who need it.3–5



  • Handling editor Josef S Smolen

  • Contributors SR drafted the response. All authors reviewed and approved the final response.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; internally peer reviewed.

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