Department of Internal Medicine, Division of Rheumatology, Ankara City Hospital, Ankara, Turkey.
Department of Infectious Diseases, Ankara City Hospital, Ankara, Turkey.
Women Health. 2021 Oct;61(9):872-879. doi: 10.1080/03630242.2021.1981517. Epub 2021 Sep 22.
Anakinra, which is an Interleukin-1 (IL-1) receptor antagonist with the advancing disease process, has started to be considered as an alternative treatment for Covid-19 patients with cytokine storms. We evaluated the effect of corticosteroids and IL-1 receptor blockage with anakinra on pregnant patients with Covid-19 at high risk for respiratory distress, ongoing fever, deterioration in their general condition and consequently maternal and fetal complications. Fourteen pregnant women who received anakinra (median dosage: 400 mg) and corticosteroid (methylprednisolone-median dosage: 80 mg) treatment were evaluated retrospectively. Patients were assessed according to the World Health Organization (WHO) scale. The mortality rate of the cohort was 7.1%, the median hospitalization period of the patients was 15 days and 2 patients had premature births. Covid-19 was found to have a similar spectrum of symptoms in pregnant and non-pregnant women, such as dyspnea, cough and fever. Our study was the first to analyze the combined treatment of corticosteroid and anakinra in pregnant patients with pneumonia from Covid-19 based on the WHO scoring system. Due to the obscurity in the treatment process in pregnant patients, studies are ongoing on managing Covid-19 infection in these patients. We presume that the early use of anakinra and corticosteroid treatments in patients severely infected with Covid-19 may have positive effects on disease progression and survival.
阿那白滞素是一种白细胞介素-1(IL-1)受体拮抗剂,在疾病进展过程中被认为是治疗 COVID-19 患者细胞因子风暴的一种替代治疗方法。我们评估了皮质类固醇和阿那白滞素对有发生呼吸窘迫、持续发热、全身状况恶化以及随之而来的母婴并发症风险的 COVID-19 高危孕妇的影响。回顾性评估了 14 名接受阿那白滞素(中位数剂量:400mg)和皮质类固醇(甲泼尼龙,中位数剂量:80mg)治疗的孕妇。患者根据世界卫生组织(WHO)标准进行评估。该队列的死亡率为 7.1%,患者的中位住院时间为 15 天,2 名患者早产。COVID-19 在孕妇和非孕妇中的症状谱相似,如呼吸困难、咳嗽和发热。我们的研究首次根据 WHO 评分系统分析了皮质类固醇和阿那白滞素联合治疗 COVID-19 肺炎的孕妇。由于孕妇治疗过程不明确,目前正在对这些患者的 COVID-19 感染进行管理研究。我们推测,早期使用阿那白滞素和皮质类固醇治疗 COVID-19 重度感染的患者可能对疾病进展和生存有积极影响。