It depends on the struct definition and types (it must describable by a type library), but yes, you can create a struct like this in C#

[ComVisible(true)]
[StructLayout(LayoutKind.Sequential)]
public struct Test
{
    public int Value1;
    public int Value2;
    etc...
}

Use it like this in the interface (and implement it in the class):

[ComVisible(true)]
public interface ICommonTest
{
    void Test(ref Test test);
}

The Visual Studio #import directive will generate code like this in the .tlh file:

struct __declspec(uuid("d80d27a3-7643-39bf-bba8-c8cc0ab10e7e"))
Test
{
    long Value1;
    long Value2;
    etc...
};

And you can use like this in C++:

ICommonTestPtr pICommonTest(__uuidof(CommonTestManaged));

Test t = {};
t.Value2 = 123456789;
pICommonTest->Test(&t);