Yordanova Ralitsa, Strashimirov Dimitar, Grozdeva Rusina, Ivanov Daniel, Trifonova Ivelina, Yancheva Nina, Tcherveniakova Tatiana
Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University Sofia, 1431 Sofia, Bulgaria.
National Laboratory "Influenza and ARD", Department of Virology, National Center of Infectious and Parasitic Diseases (NCIPD), 1504 Sofia, Bulgaria.
Biomedicines. 2024 Nov 25;12(12):2690. doi: 10.3390/biomedicines12122690.
SARS-CoV-2 can trigger hyperinflammation, leading to severe COVID-19, presenting with pneumonia, acute respiratory distress syndrome (ARDS), and multiple organ failure. Specific biomarkers like leukocytes, CRP, NLR, AST, LDH, D-dimer, ferritin, and IL-6 are associated with disease severity. Anakinra, an IL-1 receptor antagonist, has been proposed to mitigate hyperinflammation, but its clinical efficacy remains uncertain. This study aimed to evaluate the effect of Anakinra on inflammatory biomarkers, oxygenation status, and survival outcomes in hospitalized patients with moderate to severe COVID-19 (according to the National Institute of Health severity scale), compared to standard treatment. A retrospective analysis included 65 patients (mean age 75.51 ± 9.54 years; 58.5% male, 41.5% female) hospitalized with moderate to severe COVID-19. Patients were divided into two groups: a control group receiving standard treatment (n = 24) and a target group treated with Anakinra (n = 41). Biomarkers and oxygenation status were assessed on Days 0, 3, and 7. Statistical analyses compared the groups for changes in leukocytes, NLR, CRP, AST, LDH, D-dimer, ferritin, and IL-6. Anakinra treatment was associated with significant reductions in leukocytes, NLR, D-dimer, ferritin, IL-6, and CRP by Days 3 and 7. Improvements in oxygenation status were observed, although no survival benefits were noted. The control group showed no significant biomarker changes except for AST and LDH on Day 7. Anakinra demonstrated favorable effects on biomarkers and oxygenation in moderate to severe COVID-19 but did not improve survival. Further studies are needed to validate these findings.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)可引发过度炎症,导致重症冠状病毒病2019(COVID-19),表现为肺炎、急性呼吸窘迫综合征(ARDS)和多器官功能衰竭。白细胞、C反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、D-二聚体、铁蛋白和白细胞介素-6(IL-6)等特定生物标志物与疾病严重程度相关。已有人提出,白细胞介素-1受体拮抗剂阿那白滞素可减轻过度炎症,但其临床疗效仍不确定。本研究旨在评估与标准治疗相比,阿那白滞素对中度至重度COVID-19住院患者(根据美国国立卫生研究院严重程度量表)炎症生物标志物、氧合状态和生存结局的影响。一项回顾性分析纳入了65例中度至重度COVID-19住院患者(平均年龄75.51±9.54岁;男性占58.5%,女性占41.5%)。患者分为两组:接受标准治疗的对照组(n = 24)和接受阿那白滞素治疗的目标组(n = 41)。在第0、3和7天评估生物标志物和氧合状态。统计分析比较了两组白细胞、NLR、CRP、AST、LDH、D-二聚体、铁蛋白和IL-6的变化。到第3天和第7天,阿那白滞素治疗与白细胞、NLR、D-二聚体、铁蛋白、IL-6和CRP的显著降低相关。观察到氧合状态有所改善,尽管未发现生存获益。对照组除第7天的AST和LDH外,生物标志物无显著变化。阿那白滞素对中度至重度COVID-19的生物标志物和氧合有良好影响,但未改善生存率。需要进一步研究来验证这些发现。