Anakinra in hospitalized patients with severe COVID-19 pneumonia requiring oxygen therapy: Results of a prospective, open-label, interventional study
| Autor: | M.S. Al Busaidi, S Al Ruqeishi, G Al Khadouri, A. Al-Khirbash, Abdullah M Al Alawi, S Baawain, K Al Zidi, F Rehman, Ibrahim Al-Zakwani, F Yousif, S Al Mubaihsi, B Al Rawahi, Abdullah Balkhair, J Al Aghbari, N AbuDraz, M Gargouri, M Al-Ward, Wael A. Abdelmottaleb, M. Al Kindi, I Saber, Z Bin Nazar, I. Al Busaidi, Shiyam Kumar, J. P. Lal, Z Al-Naamani, B John, A Al Lawati, O Balkhair, Khalid Al-Baimani, N Elfatih, B Dawud, H BaTaher |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Adult Male musculoskeletal diseases Microbiology (medical) medicine.medical_specialty Coronavirus disease 2019 (COVID-19) medicine.medical_treatment 030106 microbiology Hyperinflammation Article lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine Mechanical ventilation Internal medicine Oxygen therapy medicine Weaning Humans lcsh:RC109-216 030212 general & internal medicine Prospective Studies COVID-19 pneumonia Prospective cohort study Aged Aged 80 and over Anakinra business.industry SARS-CoV-2 Standard treatment COVID-19 General Medicine Middle Aged medicine.disease Respiration Artificial Hospitalization Oxygen Pneumonia Interleukin 1 Receptor Antagonist Protein Infectious Diseases Female business medicine.drug |
| Zdroj: | International Journal of Infectious Diseases International Journal of Infectious Diseases, Vol 103, Iss, Pp 288-296 (2021) |
| ISSN: | 1201-9712 7472-7214 |
| DOI: | 10.1016/j.ijid.2020.11.149 |
| Popis: | Highlights • Anakinra averted need for mechanical ventilation in patients with severe COVID-19 pneumonia. • Anakinra accelerated weaning off oxygen therapy and hastened transition to room air. • Patients treated with anakinra had significant reduction in biomarkers of inflammation. • Study results did not demonstrate significant difference in in-hospital mortality. • We provided further evidence for the utility of anakinra in severe COVID-19 pneumonia. Objective To evaluate the efficacy of anakinra in patients who were admitted to hospital for severe COVID-19 pneumonia requiring high oxygen therapy. Methods A prospective, open-label, interventional study in adults hospitalized with severe COVID-19 pneumonia was conducted. Patients in the interventional arm received subcutaneous anakinra (100 mg twice daily for 3 days, followed by 100 mg daily for 7 days) in addition to standard treatment. Main outcomes were need for mechanical ventilation and in-hospital death. Secondary outcomes included successful weaning from supplemental oxygen and change in inflammatory biomarkers. Outcomes were compared with those of historical controls who received standard treatment and supportive care. Results A total of 69 patients were included; 45 anakinra-treated and 24 historical controls. Need for mechanical ventilation occurred in 14 (31%) in the anakinra-treated group and 18 (75%) in the historical cohort (p < 0.001). In-hospital death occurred in 13 (29%) in the anakinra-treated group and 11 (46%) in the historical cohort (p = 0.082). Successful weaning from supplemental oxygen to ambient air was attained in 25 (63%) in the anakinra-treated compared with 6 (27%) in the historical cohort (p = 0.008). Patients who received anakinra showed significant reduction in inflammatory biomarkers. Conclusion In patients with severe COVID-19 pneumonia and high oxygen requirement, anakinra could represent an effective treatment option and may confer clinical benefit. Trial registration number ISRCTN74727214. |
| Databáze: | OpenAIRE |
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