* sofa score\> 6 points * patient who, in the researcher's opinion, is not a subsidiary of invasive mechanical ventilation * neutrophil count \<2 x 103 / μl * platelet count \<100 x 103 / μl * alt or ast levels\> 5 times the upper limit of normal * severe renal failure (crcr \<30 ml / min) * active bacterial infectious process * active tuberculosis, history of not completing treatment against tuberculosis, suspicion of extrapulmonary tuberculosis * history of intestinal ulcer or diverticulitis * history of hypersensitivity reactions to sarilumab or its excipients * treatment with tnf antagonists * previous treatment with anti-il6 in the previous 30 days * chronic prior treatment with corticosteroids at doses greater than 0.5 mg / kg / day of prednisone or equivalent. yes, inhaled and topical corticosteroids are acceptable * concomitant treatment with immunomodulators, among which are vitamin d or statins. macrolides such as azithromycin are acceptable * patients on immunosuppressive treatment for any cause * hiv-infected patients with cd4 \<200 / mm3 * past or current history of autoimmune disease or systemic inflammatory disease * patients who have received or are planning therapy with immunomodulatory antibodies, including immunoglobulins * participation in any clinical trial that evaluated any investigational product in the last 3 months or less than 5 half-lives of the investigational product * pregnancy * any other condition that, in clinical judgment, prevents adherence to the patient's protocol

* sofa score\> 6 points * patient who, in the researcher's opinion, is not a subsidiary of invasive mechanical ventilation * neutrophil count \<2 x 103 / μl * platelet count \<100 x 103 / μl * alt or ast levels\> 5 times the upper limit of normal * severe renal failure (crcr \<30 ml / min) * active bacterial infectious process * active tuberculosis, history of not completing treatment against tuberculosis, suspicion of extrapulmonary tuberculosis * history of intestinal ulcer or diverticulitis * history of hypersensitivity reactions to sarilumab or its excipients * treatment with tnf antagonists * previous treatment with anti-il6 in the previous 30 days * chronic prior treatment with corticosteroids at doses greater than 0.5 mg / kg / day of prednisone or equivalent. yes, inhaled and topical corticosteroids are acceptable * concomitant treatment with immunomodulators, among which are vitamin d or statins. macrolides such as azithromycin are acceptable * patients on immunosuppressive treatment for any cause * hiv-infected patients with cd4 \<200 / mm3 * past or current history of autoimmune disease or systemic inflammatory disease * patients who have received or are planning therapy with immunomodulatory antibodies, including immunoglobulins * participation in any clinical trial that evaluated any investigational product in the last 3 months or less than 5 half-lives of the investigational product * pregnancy * any other condition that, in clinical judgment, prevents adherence to the patient's protocol

- sofa score> 6 points - patient who, in the researcher's opinion, is not a subsidiary of invasive mechanical ventilation - neutrophil count <2 x 103 / μl - platelet count <100 x 103 / μl - alt or ast levels> 5 times the upper limit of normal - severe renal failure (crcr <30 ml / min) - active bacterial infectious process - active tuberculosis, history of not completing treatment against tuberculosis, suspicion of extrapulmonary tuberculosis - history of intestinal ulcer or diverticulitis - history of hypersensitivity reactions to sarilumab or its excipients - treatment with tnf antagonists - previous treatment with anti-il6 in the previous 30 days - chronic prior treatment with corticosteroids at doses greater than 0.5 mg / kg / day of prednisone or equivalent. yes, inhaled and topical corticosteroids are acceptable - concomitant treatment with immunomodulators, among which are vitamin d or statins. macrolides such as azithromycin are acceptable - patients on immunosuppressive treatment for any cause - hiv-infected patients with cd4 <200 / mm3 - past or current history of autoimmune disease or systemic inflammatory disease - patients who have received or are planning therapy with immunomodulatory antibodies, including immunoglobulins - participation in any clinical trial that evaluated any investigational product in the last 3 months or less than 5 half-lives of the investigational product - pregnancy - any other condition that, in clinical judgment, prevents adherence to the patient's protocol

- sofa score> 6 points - patient who, in the researcher's opinion, is not a subsidiary of invasive mechanical ventilation - neutrophil count <2 x 103 / μl - platelet count <100 x 103 / μl - alt or ast levels> 5 times the upper limit of normal - severe renal failure (crcr <30 ml / min) - active bacterial infectious process - active tuberculosis, history of not completing treatment against tuberculosis, suspicion of extrapulmonary tuberculosis - history of intestinal ulcer or diverticulitis - history of hypersensitivity reactions to sarilumab or its excipients - treatment with tnf antagonists - previous treatment with anti-il6 in the previous 30 days - chronic prior treatment with corticosteroids at doses greater than 0.5 mg / kg / day of prednisone or equivalent. yes, inhaled and topical corticosteroids are acceptable - concomitant treatment with immunomodulators, among which are vitamin d or statins. macrolides such as azithromycin are acceptable - patients on immunosuppressive treatment for any cause - hiv-infected patients with cd4 <200 / mm3 - past or current history of autoimmune disease or systemic inflammatory disease - patients who have received or are planning therapy with immunomodulatory antibodies, including immunoglobulins - participation in any clinical trial that evaluated any investigational product in the last 3 months or less than 5 half-lives of the investigational product - pregnancy - any other condition that, in clinical judgment, prevents adherence to the patient's protocol