- "9-category ordinal severity scale ranging from
0 (asymptomatic patient) to 8 (a critically ill patient with tracheal intubation, mechanical ventilation and advanced ICU management"

- "The BCRSS has been developed through multiple interactions
by a multidisciplinary team of intensive care physicians, infectious
disease specialists, pneumologists, internists, rheumatologists and immunologists to rapidly assess the patients' respiratory condition. BCRSS
classifies the patients' severity based on the need for oxygen supplementation and ventilatory support, offering a step-up therapeutic approach for the use of antiviral and anti-inflammatory drugs. The scale
was rapidly adopted at a regional level and used to define pragmatically
the patient's response to treatment "

Brescia COVID-19 Respiratory Severity Scale (BCRSS)

BCRSS scores decreased overall for all patients given TCZ transfusion, showing clinical improvements, but not necessarily statistical significance.

University of Michigan - Ann Arbor

- "At 24–72 h after TCZ administration, 58 patients (58%) showed a
rapid improvement of clinical and respiratory condition, 37 (37%)
stabilized compared to the rapidly declining pre-TCZ condition, and 5
(5%) worsened (of whom 4 died)"

- BCRSS scores decreased on average, but had a similar range of values. See figure in child node "Figure 2. Changes in Brescia COVID-19 Respiratory Severity Scale (BCRSS) among 100 severe COVID-19 patients in Brescia, Italy during 10-day follow-up after Tocilizumab (TCZ) infusion"

Outcomes among 100 severe COVID-19 patients in Brescia, Italy  24–72 h after Tocilizumab (TCZ) infusion

- "At 10 days, the respiratory condition was improved or stabilized in
77 (77%) patients, of whom 61 showed a significant clearing of diffuse
bilateral opacities on chest x-ray and 15 were discharged from the
hospital. Respiratory condition worsened in 23 (23%) patients, of
whom 20 (20%) died."

- "Of the 57 patients treated outside the ICU, 37 (65%) improved and
suspended NIV (BCRSS 1 [IQR 0–2]), 7 (12%) patients remained stable in NIV, and 13 (23%) patients worsened (10 died, 3 were admitted to
ICU)."

- "Of the 43 patients treated in the ICU, 32 (74%) improved (17 of
them were taken off the ventilator and were discharged to the ward), 1
(2%) remained stable (BCRSS class 5) and 10 (24%) died (all of them
had BCRSS≥7 before TCZ)."

- BCRSS scores decreased on average, but had a similar range of values. See figure in child node "Figure 2. Changes in Brescia COVID-19 Respiratory Severity Scale (BCRSS) among 100 severe COVID-19 patients in Brescia, Italy during 10-day follow-up after Tocilizumab (TCZ) infusion"

- Three severe adverse outcomes measured: 2 patients developed  septic shock and died, 1 patient developed GI perforation and required surgery

Outcomes among 100 severe COVID-19 patients in Brescia, Italy  10 days after Tocilizumab (TCZ) infusion

Toniati P, Piva S, Cattalini M, et al. Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy. Autoimmun Rev. 2020;19(7):102568. 

doi:10.1016/j.autrev.2020.102568

Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy

Figure 2. Changes in Brescia COVID-19 Respiratory Severity Scale (BCRSS) among 100 severe COVID-19 patients in Brescia, Italy during 10-day follow-up after Tocilizumab (TCZ) infusion

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