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What is known and objective: The coronavirus disease 2019 (COVID‐19) associated cytokine activation can lead to a rapid progression into respiratory failure, shock and multiorgan failure. Interleukin‐6 (IL‐6) is a pro‐inflammatory cytokine that likely contributes to the pathogenesis of cytokine release syndrome. It is hypothesized that modulating IL‐6 levels or its effects with tocilizumab, a recombinant humanized anti‐IL‐6 receptor monoclonal antibody, may alter the course of disease. Methods: We examined the association between tocilizumab use and intubation or death at a community hospital in New York City. Data were obtained regarding consecutive patients hospitalized with COVID‐19. The primary end point was a composite of intubation or death in a time‐to‐event analysis. We compared outcomes in patients who received tocilizumab with those in patients who did not, using a multivariable Cox model with inverse probability weighting according to the propensity score. Results and Discussion: In this single‐centre retrospective cohort study involving 1225 hospitalized patients with SARS‐CoV‐2 infection, the probability to respiratory failure, which was measured as intubation or death, was less frequent in patients who received tocilizumab. What is new and conclusion: Tocilizumab and other IL‐6 receptor monoclonal antibodies may evolve as a viable option in treating patients with moderate and severe COVID‐19. [ABSTRACT FROM AUTHOR]