Immunosuppressive strategies in invasively ventilated ARDS COVID-19 patients.
Minerva Anestesiol
; 87(8): 891-902, 2021 08.
Article
in English
| MEDLINE | ID: covidwho-1262728
ABSTRACT
BACKGROUND:
COVID-19 is associated with elevated levels of inflammatory cytokines. We present the characteristics and outcomes of patients treated in the Intensive Care Unit (ICU) with immunosuppressive drugs, either tocilizumab or anakinra compared with controls.METHODS:
A single-center observational prospective study on ICU invasively ventilated COVID-19 patients. The primary outcome was the clinical improvement at day 28. A Bayesian framework was employed, and all analyses were adjusted for confounders.RESULTS:
Sixty-one consecutive invasively ventilated patients were included, nine (14.7%) received tocilizumab and 15 (24.6%) received anakinra. Over the first seven days, tocilizumab was associated with a greater decrease in C-reactive protein (P<0.001). After adjusting for confounders, the probability of clinical improvement at day 28 compared to control was 7â6% (OR=0.36 [95% CrI 0.09-1.46]) for tocilizumab and 40.9% (OR=0.89 [95% CrI 0.32-2.43]) for anakinra. At day 28, the probability of being in a better clinical category was 2.5% (OR=2.98 [95% CrI 1.00-8.88]) for tocilizumab, and 49.5% (OR=1.00 [95% CrI 0.42-2.42]) for anakinra.CONCLUSIONS:
In invasively ventilated COVID-19 patients, treatment with anakinra was associated with a higher probability of clinical improvement compared to tocilizumab; however, treatment with either drug did not result in clinically meaningful improvements compared with controls.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Respiratory Distress Syndrome
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Minerva Anestesiol
Year:
2021
Document Type:
Article
Affiliation country:
S0375-9393.21.15339-8
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