Siyer Ozge, Aksakal Berrin, Basat Sema
Department of Internal Medicine, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkiye.
North Clin Istanb. 2023 Apr 19;10(2):189-196. doi: 10.14744/nci.2022.01047. eCollection 2023.
Some anti-cytokine treatments are being used to control the hyperinflammatory condition defined as cytokine storm that develops during COVID-19 infection. In this study, we aim to investigate the effects of anakinra, an IL-1 antagonist, on the clinical status and laboratory values of hospitalized patients with the COVID-19 infection. The aim of the study was to investigate the effects of anakinra, an IL-1 antagonist, on the clinical and laboratory results of hospitalized patients with COVID-19 infection.
This study was planned as a retrospective study. The age, gender, and current comorbidities of a total of 66 patients who were treated with anakinra for COVID-19 infection from November 2020 to January 2021 were analyzed. The amount of oxygen demand (L/s), the type of oxygen supplementation, oxygen saturation, radiological findings, WBC count, lymphocyte count, neutrophil count, C-reactive protein, LDH, ferritin, fibrinogen, D-dimer levels were monitored before the treatment, and after the anakinra treatment, newly gathered results were compared. Patients' hospitalization period, oxygen need, and their clinical status at discharge were evaluated. The effects of early anakinra treatment (9 days before and after the onset of symptoms) on the prognosis were evaluated. SPSS version 21.0 provided by IBM Company in the USA, Chicago, IL was used for statistical analysis and p<0.05 was considered significant.
Sixty-six patients were included in the study. There was no significant gender difference in the prognosis of the patients. There was a significant difference in the statistical deterioration in patients with comorbidities (p=0.004). Patients who started the anakinra treatment at an early stage developed less need for intensive care and low mortality ratios (p=0.019). There were significant improvements on the levels of WBC (p=0.045), neutrophils (p=0.016), lymphocyte (p=0.001), LDH (p=0.005), ferritin (p=0.02), and fibrinogen (p=0.01) after the administration of anakinra therapy.
We found that earlier and appropriate use of anakinra therapy in COVID-19 patients with the signs of macrophage activation syndrome reduces the need for oxygen support in patients and contributes to improvement in laboratory results and radiological findings, and most importantly reduces the need for intensive care.
一些抗细胞因子治疗正在用于控制在新型冠状病毒肺炎(COVID-19)感染期间出现的被定义为细胞因子风暴的高炎症状态。在本研究中,我们旨在调查白细胞介素-1拮抗剂阿那白滞素对COVID-19感染住院患者临床状况和实验室检查值的影响。本研究的目的是调查白细胞介素-1拮抗剂阿那白滞素对COVID-19感染住院患者临床和实验室检查结果的影响。
本研究设计为一项回顾性研究。分析了2020年11月至2021年1月期间共66例接受阿那白滞素治疗COVID-19感染患者的年龄、性别和当前合并症。监测治疗前的需氧量(升/秒)、氧疗类型、血氧饱和度、影像学检查结果、白细胞计数、淋巴细胞计数、中性粒细胞计数、C反应蛋白、乳酸脱氢酶、铁蛋白、纤维蛋白原、D-二聚体水平,并将阿那白滞素治疗后新获得的结果进行比较。评估患者的住院时间、氧需求以及出院时的临床状况。评估早期阿那白滞素治疗(症状出现前后9天)对预后的影响。使用美国伊利诺伊州芝加哥市IBM公司提供的SPSS 21.0版本进行统计分析,p<0.05被认为具有统计学意义。
66例患者纳入本研究。患者预后在性别上无显著差异。合并症患者的统计学恶化存在显著差异(p=0.004)。早期开始阿那白滞素治疗的患者对重症监护的需求较少且死亡率较低(p=0.019)。给予阿那白滞素治疗后,白细胞(p=0.045)、中性粒细胞(p=0.016)、淋巴细胞(p=0.001)、乳酸脱氢酶(p=0.005)、铁蛋白(p=0.02)和纤维蛋白原(p=0.01)水平有显著改善。
我们发现,在有巨噬细胞活化综合征迹象的COVID-19患者中更早且适当地使用阿那白滞素治疗可减少患者对氧支持的需求,并有助于改善实验室检查结果和影像学检查结果,最重要的是减少对重症监护的需求。