Background: Interleukin-6 receptor antagonists (IL-6RAs) and steroids are emerging immunomodulatory therapies for severe and critical coronavirus disease (COVID-19). In this preliminary report, we aim to describe the epidemiology, clinical characteristics, and outcomes of adult critically ill COVID-19 patients, Aim: to evaluate whether the immunomodulation with an IL-6 antagonist is associated with an improved hemostasis in patients with COVID-19 as measured by viscoelastic tests. Materials and methods: This prospective study was conducted in Kirkuk city – Iraq, from the first of March 2021 until the end of June 2021. The study included 50 patients from both sexes with age above (18-60) years. Clinical and laboratory parameters, such as blood pressure (systolic, diastolic), heart rate, peripheral capillary oxygen saturation (SpO2), respiratory rate, body temperature, disease severity scores, ventilation parameters, blood gas parameters, VHA results will be recorded at set time intervals (see later). All the medication that the patient has taken during the study period will be noted. Blood culture samples will also be taken when indicated to exclude superinfection thus ensuring that these will not influence the results of the study. Blood sample was collected by vein puncture from each subject enrolled in this study . for determination of ALT, AST, LDH , S. creatinine, BUN , TSB and S . Albumin . The primary outcome is the change of the Lab parameters measured before IL-6 antagonist and 2 weeks after immunomodulation therapy of IL-6 antagonist. As and the effect of it are relatively shortly seen in inflammatory parameters after administration, we decided to use the parameters. In addition, the study will investigate the following secondary outcomes