Limitations
fever
The relatively few patients included precludes firm conclusions from this study. Other limitations include the open-label design. This was chosen in part because tocilizumab use is hard to mask given its normalizing effects on fever and CRP, in part because placebo procedures would have taken too long to set in motion. All patients were recruited at tertiary university hospitals, the absolute majority from Karolinska University hospital in south Stockholm, which limits external validity. The proportion of patients that received remdesivir as part of usual care was highest in the tocilizumab group and lowest in the anakinra group, but since duration of illness per inclusion criteria was at least seven days, and since remdesivir likely has minimal effect when administered late in immunocompetent patients with covid-19, this is unlikely to have affected outcome. Patients were continuously assessed for eligibility, but due to high workload, reasons for non-eligibility were not registered.