Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA.
Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA.
J Asthma. 2022 Apr;59(4):780-786. doi: 10.1080/02770903.2021.1881967. Epub 2021 Mar 4.
Several therapeutic agents have been assessed for the treatment of COVID-19, but few approaches have been proven efficacious. Because leukotriene receptor antagonists, such as montelukast have been shown to reduce both cytokine release and lung inflammation in preclinical models of viral influenza and acute respiratory distress syndrome, we hypothesized that therapy with montelukast could be used to treat COVID-19. The objective of this study was to determine if montelukast treatment would reduce the rate of clinical deterioration as measured by the COVID-19 Ordinal Scale.
We performed a retrospective analysis of COVID-19 confirmed hospitalized patients treated with or without montelukast. We used "clinical deterioration" as the primary endpoint, a binary outcome defined as any increase in the Ordinal Scale value from Day 1 to Day 3 of the hospital stay, as these data were uniformly available for all admitted patients before hospital discharge. Rates of clinical deterioration between the montelukast and non-montelukast groups were compared using the Fisher's exact test. Univariate logistic regression was also used to assess the association between montelukast use and clinical deterioration. A total of 92 patients were analyzed, 30 who received montelukast at the discretion of the treating physician and 62 patients who did not receive montelukast.
Patients receiving montelukast experienced significantly fewer events of clinical deterioration compared with patients not receiving montelukast (10% vs 32%, = 0.022). Our findings suggest that montelukast associates with a reduction in clinical deterioration for COVID-19 confirmed patients as measured on the COVID-19 Ordinal Scale.
Hospitalized COVID-19 patients treated with montelukast had fewer events of clinical deterioration, indicating that this treatment may have clinical activity. While this retrospective study highlights a potential pathway for COVID-19 treatment, this hypothesis requires further study by prospective studies.
已经评估了几种治疗 COVID-19 的治疗药物，但很少有方法被证明是有效的。由于白三烯受体拮抗剂，如孟鲁司特，已被证明可减少临床前流感病毒和急性呼吸窘迫综合征模型中的细胞因子释放和肺炎症，我们假设孟鲁司特治疗可用于治疗 COVID-19。本研究的目的是确定孟鲁司特治疗是否会降低 COVID-19 序数量表测量的临床恶化率。
我们对接受或未接受孟鲁司特治疗的 COVID-19 确诊住院患者进行了回顾性分析。我们将“临床恶化”作为主要终点，这是一种二进制结局，定义为住院期间第 1 天至第 3 天 Ordinal Scale 值的任何增加，因为这些数据在所有入院患者出院前均普遍可用。使用 Fisher 精确检验比较孟鲁司特组和非孟鲁司特组之间的临床恶化发生率。还使用单变量逻辑回归评估孟鲁司特使用与临床恶化之间的关联。共分析了 92 例患者，其中 30 例根据治疗医生的判断接受了孟鲁司特治疗，62 例未接受孟鲁司特治疗。
接受孟鲁司特治疗的患者与未接受孟鲁司特治疗的患者相比，临床恶化事件明显减少（10%对 32%，=0.022）。我们的研究结果表明，孟鲁司特与 COVID-19 确诊患者 COVID-19 序数量表上的临床恶化减少相关。
接受孟鲁司特治疗的住院 COVID-19 患者临床恶化事件减少，表明该治疗可能具有临床活性。虽然这项回顾性研究强调了 COVID-19 治疗的潜在途径，但这一假设需要通过前瞻性研究进一步研究。
