Alpha-1 adrenergic receptor antagonists to prevent hyperinflammation and death from lower respiratory tract infection.
Elife
; 102021 06 11.
Article
in English
| MEDLINE | ID: covidwho-1266916
ABSTRACT
In severe viral pneumonia, including Coronavirus disease 2019 (COVID-19), the viral replication phase is often followed by hyperinflammation, which can lead to acute respiratory distress syndrome, multi-organ failure, and death. We previously demonstrated that alpha-1 adrenergic receptor (âº1-AR) antagonists can prevent hyperinflammation and death in mice. Here, we conducted retrospective analyses in two cohorts of patients with acute respiratory distress (ARD, n = 18,547) and three cohorts with pneumonia (n = 400,907). Federated across two ARD cohorts, we find that patients exposed to âº1-AR antagonists, as compared to unexposed patients, had a 34% relative risk reduction for mechanical ventilation and death (OR = 0.70, p = 0.021). We replicated these methods on three pneumonia cohorts, all with similar effects on both outcomes. All results were robust to sensitivity analyses. These results highlight the urgent need for prospective trials testing whether prophylactic use of âº1-AR antagonists ameliorates lower respiratory tract infection-associated hyperinflammation and death, as observed in COVID-19.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Respiration, Artificial
/
Respiratory Distress Syndrome
/
Adrenergic alpha-1 Receptor Antagonists
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Aged
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
/
Europa
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
ELife.61700
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