Interleukin-6 Guided Treatment With Dexamethasone or Tocilizumab in Patients Hospitalized With Acute Respiratory Symptoms - a Feasibility Study

Inclusion Criteria 1. Age ≥18 years 2. Presence of new onset of respiratory symptoms in the previous 14 days upon presentation at the emergency department. Respiratory symptoms are characterized by at least one of the following: cough, dyspnea, or requirement of oxygen supplementation 3. Requirement of inpatient hospital management Exclusion Criteria General Exclusion: 1. Inability to provide informed consent 2. Immediate need for admission to ICU 3. Immediate need for intubation 4. Imminent death 5. Clinical team refusal Randomization Exclusion 1. Patients with known contraindications to dexamethasone or tocilizumab, or any of their components 2. Allergic reaction to tocilizumab or other monoclonal antibodies 3. Patients who are using azathioprine or cyclophosphamide 4. Active tuberculosis infection 5. ALT or AST \>10x upper limit of normal 6. Neutrophil count \<1000/mcl 7. Platelet count \<50,000/mm3 8. Patients already receiving systemic steroids, monoclonal antibodies or other immunosuppressive medications at the time of presentation 9. Inability to comply with the regulations to avoid conception within 28 days after enrollment 10. Any serious medical condition or abnormality of clinical laboratory tests that, in the investigator's judgment, precludes the patient's safe participation in and completion of the study 11. Participation in other drug clinical trials (this criterion will be discussed with the PI) 12. Reaching \>72h since hospital admission 13. Admission to ICU prior to randomization 14. Pregnancy (positive pregnancy test) or breastfeeding (which is a contraindication to tocilizumab)