Infectious & Tropical Diseases Unit, "Annunziata" Hospital, Azienda Ospedaliera di Cosenza, Cosenza, Italy.
Hospital Pharmacy, "Annunziata" Hospital, Azienda Ospedaliera di Cosenza, Cosenza, Italy.
Int J Immunopathol Pharmacol. 2023 Jan-Dec;37:3946320231189993. doi: 10.1177/03946320231189993.
The dysregulated immune response occurring upon COVID-19 infection can lead to tissue damage and organ failure. Different therapeutic strategies are needed to cope with the current and future outspread of COVID-19, including antiviral and anti-inflammatory agents. We describe the outcome of hospitalized patients treated with canakinumab and remdesivir plus the standard of care therapy. This observational study describes the outcome of the combination of canakinumab (450 mg for patients ≥40 and <60 kg, 600 mg for those ≥60 and <80 kg, or 750 mg for patients ≥80 kg) and 200 mg remdesivir intravenous infusion, plus standard of care (SOC), in 17 moderate-to-severe COVID-19 patients hospitalized in the "Annunziata" Hospital, Cosenza, Italy, between August and November 2021. Hematological markers, biochemical, and hemogasanalysis values at baseline versus day 7 of combination treatment were compared by paired test after checking for normal distribution and correcting for multiple comparison. The median age of patients was 64 years (range: 39-85), and the median hospitalization time (calculated on the 16 patients that were not transferred to intensive care unit) was of 12.5 days (range: 7-35 days); 15/17 patients (88%) did not experience complications. After 7 days of combination therapy, all the inflammatory parameters were significantly reduced with the exception of procalcitonin; moreover, hematological prognostic markers such neutrophil-to-lymphocyte ratio, CRP-to-lymphocyte ratio, and derived neutrophil-to-lymphocyte ratio reduced. Overall, 16/17 patients (94%) recovered after 14 days. Canakinumab and remdesivir treatment, in addition to SOC, in the early stage of moderate-to-severe COVID-19 showed promising outcomes in terms of safety and effectiveness potentially leading to a reduction in inflammatory and hematological prognostic markers after 7 days of treatment.
COVID-19 感染引起的失调免疫反应可导致组织损伤和器官衰竭。需要不同的治疗策略来应对当前和未来 COVID-19 的蔓延，包括抗病毒和抗炎药物。我们描述了接受卡那单抗和瑞德西韦联合标准治疗的住院患者的结局。这项观察性研究描述了卡那单抗（体重<60kg 的患者给予 450mg，体重≥60kg 且<80kg 的患者给予 600mg，体重≥80kg 的患者给予 750mg）联合 200mg 瑞德西韦静脉输注，联合标准治疗（SOC），在 2021 年 8 月至 11 月期间，意大利科森扎“Annunziata”医院收治的 17 例中重度 COVID-19 住院患者中的应用效果。对组合治疗第 7 天与基线时的血液学标志物、生化和血气分析值进行比较，检查正态分布后，采用配对 t 检验，并对多次比较进行校正。患者的中位年龄为 64 岁（范围：39-85 岁），中位住院时间（计算未转入重症监护病房的 16 例患者）为 12.5 天（范围：7-35 天）；17 例患者中有 15 例（88%）未发生并发症。联合治疗 7 天后，除降钙素原外，所有炎症参数均显著降低；此外，中性粒细胞与淋巴细胞比值、CRP 与淋巴细胞比值和衍生中性粒细胞与淋巴细胞比值等血液学预后标志物也降低。总的来说，17 例患者中有 16 例（94%）在 14 天后康复。卡那单抗和瑞德西韦联合 SOC 在中重度 COVID-19 的早期治疗中显示出良好的疗效和安全性，在治疗 7 天后可能降低炎症和血液学预后标志物。
