- need for mechanical ventilation for 24 hours or more before the randomization - hypersensitivity to tocilizumab - patients without therapeutic perspective or in palliative care - active non controlled infections - other clinical conditions that contraindicate tocilizumab, according to the assistant physician - low neutrophils count (< 0.5 x 109/l) - low platelets count (< 50 x 109/l) - liver disease, cirrhosis or elevated ast or alt above 5 times the upper level limit - renal disease with estimate glomerular filtration below 30 ml/min/1.72 m2 (mdrd or ckd-epi scores) - active diverticulitis - breastfeeding women - pregnancy

- need for mechanical ventilation for 24 hours or more before the randomization - hypersensitivity to tocilizumab - patients without therapeutic perspective or in palliative care - active non controlled infections - other clinical conditions that contraindicate tocilizumab, according to the assistant physician - low neutrophils count (< 0.5 x 109/l) - low platelets count (< 50 x 109/l) - liver disease, cirrhosis or elevated ast or alt above 5 times the upper level limit - renal disease with estimate glomerular filtration below 30 ml/min/1.72 m2 (mdrd or ckd-epi scores) - active diverticulitis - breastfeeding women - pregnancy