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The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients

Yıl 2022, Cilt: 75 Sayı: 3, 400 - 405, 18.10.2022

Emine Uslu Yurteri

Öz

Objectives: Coronavirus disease-2019 (COVID-19) spreads quickly all over the world. Interleukin-1 (IL-1) is a proinflammatory cytokine associated with SARS-CoV-2, causing lung damage. Anakinra is an IL-1 receptor antagonist. In this study, we aimed to describe the characteristics of COVID-19 patients who survived after anakinra treatment.

Materials and Methods: Forty-four patients who did not respond to pulse steroid treatment and were given 8 mg/kg Anakinra were included in this study. The clinical, laboratory, and imaging [thorax computed tomography (CT)] findings of survivors and non-survivors who received anakinra treatment were compared.

Results: Most of the patients were male (81.8%), the median follow-up period was 19.5 (IQR 15.5) days. Of the patients, 40.9% died. The median age was higher (p<0.001), and diabetes mellitus was more common (p<0.034) in non-survivors. In multivariate cox regression analysis, the presence of underlying hypertension (p=0.017) and pure ground glass opacity (GGO) on thorax CT at first admission to hospital (p=0.04) were found to be independent risk factors for mortality in COVID-19 patients treated with anakinra.

Conclusion: The presence of hypertension in COVID-19 patients and the presence of pure GGO on thorax CT at first admission to the hospital are the findings that may reduce the response to anakinra treatment. Prospective studies with larger patient populations are needed to demonstrate the validity of this finding.

Anahtar Kelimeler

COVID-19 Anakinra Hypertension

Etik Beyan

Ethics Committee Approval: Mustafa Kemal University Faculty of Medicine, Clinical Research Ethics Committee approval was provided for the study (approval date/no: 4.2.2020-02). Informed Consent: Written informed consent for the off-label use of steroids and anakinra were obtained from all patients. Peer-reviewed: Externally peer-reviewed.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

  • 1. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708-1720.
  • 2. Yang L, Liu S, Liu J, et al. COVID-19: immunopathogenesis and Immunotherapeutics. Signal Transduct Target Ther. 2020;5:128.
  • 3. Liao M, Liu Y, Yuan J, et al. Single-cell landscape of bronchoalveolar immune cells in patients with COVID-19. Nat Med. 2020;26:842-844.
  • 4. Mastroianni A, Greco S, Chidichimo L, et al. Early use of canakinumab to prevent mechanical ventilation in select COVID-19 patients: A retrospective, observational analysis. Int J Immunopathol Pharmacol. 2021;35:20587384211059675.
  • 5. Lopalco G, Rigante D, Giannini M, et al. Safety profile of anakinra in the management of rheumatologic, metabolic and autoinflammatory disorders. Clin Exp Rheumatol. 2016;34:531-538.
  • 6. Monteagudo LA, Boothby A, Gertner E. Continuous Intravenous Anakinra Infusion to Calm the Cytokine Storm in Macrophage Activation Syndrome. ACR Open Rheumatol. 2020;2:276-282.
  • 7. Aouba A, Baldolli A, Geffray L, et al. Targeting the inflammatory cascade with anakinra in moderate to severe COVID-19 pneumonia: case series. Ann Rheum Dis. 2020;79:1381-1382.
  • 8. Balkhair A, Al-Zakwani I, Al Busaidi M, et al. Anakinra in hospitalized patients with severe COVID-19 pneumonia requiring oxygen therapy: Results of a prospective, open-label, interventional study. Int J Infect Dis. 2021;103:288-296.
  • 9. Day JW, Fox TA, Halsey R, et al. Interleukin-1 blockade with anakinra in acute leukaemia patients with severe COVID-19 pneumonia appears safe and may result in clinical improvement. Br J Haematol. 2020;190:e80-e83.
  • 10. Filocamo G, Mangioni D, Tagliabue P, et al. Use of anakinra in severe COVID-19: A case report. Int J Infect Dis. 2020;96:607-609.
  • 11. González-García A, García-Sánchez I, Lopes V, et al. Successful treatment of severe COVID-19 with subcutaneous anakinra as a sole treatment. Rheumatology (Oxford). 2020;59:2171-2173.
  • 12. Iglesias-Julián E, López-Veloso M, de-la-Torre-Ferrera N, et al. High dose subcutaneous Anakinra to treat acute respiratory distress syndrome secondary to cytokine storm syndrome among severely ill COVID-19 patients. J Autoimmun. 2020;115:102537.
  • 13. Navarro-Millán I, Sattui SE, Lakhanpal A, et al. Use of Anakinra to Prevent Mechanical Ventilation in Severe COVID-19: A Case Series. Arthritis Rheumatol. 2020;72:1990-1997.
  • 14. Pontali E, Volpi S, Antonucci G, et al. Safety and efficacy of early highdose IV anakinra in severe COVID-19 lung disease. J Allergy Clin Immunol. 2020;146:213-215.
  • 15. Cavalli G, De Luca G, Campochiaro C, et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol. 2020;2:e325-e331.
  • 16. CORIMUNO-19 Collaborative group. Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial. Lancet Respir Med. 2021;9:295-304.
  • 17. Huet T, Beaussier H, Voisin O, et al. Anakinra for severe forms of COVID-19: a cohort study. Lancet Rheumatol. 2020;2:e393-e400.
  • 18. Bernheim A, Mei X, Huang M, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. 2020;295:200463.
  • 19. Aomar-Millán IF, Salvatierra J, Torres-Parejo Ú, et al. Anakinra after treatment with corticosteroids alone or with tocilizumab in patients with severe COVID-19 pneumonia and moderate hyperinflammation. A retrospective cohort study. Intern Emerg Med. 2021;16:843-852.
  • 20. Bozzi G, Mangioni D, Minoia F, et al. Anakinra combined with methylprednisolone in patients with severe COVID-19 pneumonia and hyperinflammation: An observational cohort study. J Allergy Clin Immunol. 2021;147:561-566.e4.
  • 21. Della-Torre E, Lanzillotta M, Campochiaro C, et al. Respiratory Impairment Predicts Response to IL-1 and IL-6 Blockade in COVID-19 Patients With Severe Pneumonia and Hyper-Inflammation. Front Immunol. 2021;12:675678.
  • 22. Arulkumaran N, Thomas M, Brealey D, et al. Plasma exchange for COVID-19 thrombo-inflammatory disease. EJHaem. 2020;2:26-32.
  • 23. Lippi G, Wong J, Henry BM. Hypertension in patients with coronavirus disease 2019 (COVID-19): a pooled analysis. Pol Arch Intern Med. 2020;130:304-309.
  • 24. Wolff D, Nee S, Hickey NS, et al. Risk factors for Covid-19 severity and fatality: a structured literature review. Infection. 2021;49:15-28.
  • 25. Franzetti M, Forastieri A, Borsa N, et al. IL-1 Receptor Antagonist Anakinra in the Treatment of COVID-19 Acute Respiratory Distress Syndrome: A Retrospective, Observational Study. J Immunol. 2021;206:1569-1575.
  • 26. Lee KS. Pneumonia Associated with 2019 Novel Coronavirus: Can ComputedTomographic Findings Help Predict the Prognosis of the Disease? Korean J Radiol. 2020;21:257-258.
  • 27. Lin C, Ding Y, Xie B, et al. Asymptomatic novel coronavirus pneumonia patient outside Wuhan: The value of CT images in the course of the disease. Clin Imaging. 2020;63:7-9.
  • 28. Hejazi ME, Malek Mahdavi A, Navarbaf Z, et al. Relationship between chest CT scan findings with SOFA score, CRP, comorbidity, and mortality in ICU patients with COVID-19. Int J Clin Pract. 2021;75:e14869.

Yıl 2022, Cilt: 75 Sayı: 3, 400 - 405, 18.10.2022

Emine Uslu Yurteri

Öz

Proje Numarası

-

Kaynakça

  • 1. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708-1720.
  • 2. Yang L, Liu S, Liu J, et al. COVID-19: immunopathogenesis and Immunotherapeutics. Signal Transduct Target Ther. 2020;5:128.
  • 3. Liao M, Liu Y, Yuan J, et al. Single-cell landscape of bronchoalveolar immune cells in patients with COVID-19. Nat Med. 2020;26:842-844.
  • 4. Mastroianni A, Greco S, Chidichimo L, et al. Early use of canakinumab to prevent mechanical ventilation in select COVID-19 patients: A retrospective, observational analysis. Int J Immunopathol Pharmacol. 2021;35:20587384211059675.
  • 5. Lopalco G, Rigante D, Giannini M, et al. Safety profile of anakinra in the management of rheumatologic, metabolic and autoinflammatory disorders. Clin Exp Rheumatol. 2016;34:531-538.
  • 6. Monteagudo LA, Boothby A, Gertner E. Continuous Intravenous Anakinra Infusion to Calm the Cytokine Storm in Macrophage Activation Syndrome. ACR Open Rheumatol. 2020;2:276-282.
  • 7. Aouba A, Baldolli A, Geffray L, et al. Targeting the inflammatory cascade with anakinra in moderate to severe COVID-19 pneumonia: case series. Ann Rheum Dis. 2020;79:1381-1382.
  • 8. Balkhair A, Al-Zakwani I, Al Busaidi M, et al. Anakinra in hospitalized patients with severe COVID-19 pneumonia requiring oxygen therapy: Results of a prospective, open-label, interventional study. Int J Infect Dis. 2021;103:288-296.
  • 9. Day JW, Fox TA, Halsey R, et al. Interleukin-1 blockade with anakinra in acute leukaemia patients with severe COVID-19 pneumonia appears safe and may result in clinical improvement. Br J Haematol. 2020;190:e80-e83.
  • 10. Filocamo G, Mangioni D, Tagliabue P, et al. Use of anakinra in severe COVID-19: A case report. Int J Infect Dis. 2020;96:607-609.
  • 11. González-García A, García-Sánchez I, Lopes V, et al. Successful treatment of severe COVID-19 with subcutaneous anakinra as a sole treatment. Rheumatology (Oxford). 2020;59:2171-2173.
  • 12. Iglesias-Julián E, López-Veloso M, de-la-Torre-Ferrera N, et al. High dose subcutaneous Anakinra to treat acute respiratory distress syndrome secondary to cytokine storm syndrome among severely ill COVID-19 patients. J Autoimmun. 2020;115:102537.
  • 13. Navarro-Millán I, Sattui SE, Lakhanpal A, et al. Use of Anakinra to Prevent Mechanical Ventilation in Severe COVID-19: A Case Series. Arthritis Rheumatol. 2020;72:1990-1997.
  • 14. Pontali E, Volpi S, Antonucci G, et al. Safety and efficacy of early highdose IV anakinra in severe COVID-19 lung disease. J Allergy Clin Immunol. 2020;146:213-215.
  • 15. Cavalli G, De Luca G, Campochiaro C, et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol. 2020;2:e325-e331.
  • 16. CORIMUNO-19 Collaborative group. Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial. Lancet Respir Med. 2021;9:295-304.
  • 17. Huet T, Beaussier H, Voisin O, et al. Anakinra for severe forms of COVID-19: a cohort study. Lancet Rheumatol. 2020;2:e393-e400.
  • 18. Bernheim A, Mei X, Huang M, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. 2020;295:200463.
  • 19. Aomar-Millán IF, Salvatierra J, Torres-Parejo Ú, et al. Anakinra after treatment with corticosteroids alone or with tocilizumab in patients with severe COVID-19 pneumonia and moderate hyperinflammation. A retrospective cohort study. Intern Emerg Med. 2021;16:843-852.
  • 20. Bozzi G, Mangioni D, Minoia F, et al. Anakinra combined with methylprednisolone in patients with severe COVID-19 pneumonia and hyperinflammation: An observational cohort study. J Allergy Clin Immunol. 2021;147:561-566.e4.
  • 21. Della-Torre E, Lanzillotta M, Campochiaro C, et al. Respiratory Impairment Predicts Response to IL-1 and IL-6 Blockade in COVID-19 Patients With Severe Pneumonia and Hyper-Inflammation. Front Immunol. 2021;12:675678.
  • 22. Arulkumaran N, Thomas M, Brealey D, et al. Plasma exchange for COVID-19 thrombo-inflammatory disease. EJHaem. 2020;2:26-32.
  • 23. Lippi G, Wong J, Henry BM. Hypertension in patients with coronavirus disease 2019 (COVID-19): a pooled analysis. Pol Arch Intern Med. 2020;130:304-309.
  • 24. Wolff D, Nee S, Hickey NS, et al. Risk factors for Covid-19 severity and fatality: a structured literature review. Infection. 2021;49:15-28.
  • 25. Franzetti M, Forastieri A, Borsa N, et al. IL-1 Receptor Antagonist Anakinra in the Treatment of COVID-19 Acute Respiratory Distress Syndrome: A Retrospective, Observational Study. J Immunol. 2021;206:1569-1575.
  • 26. Lee KS. Pneumonia Associated with 2019 Novel Coronavirus: Can ComputedTomographic Findings Help Predict the Prognosis of the Disease? Korean J Radiol. 2020;21:257-258.
  • 27. Lin C, Ding Y, Xie B, et al. Asymptomatic novel coronavirus pneumonia patient outside Wuhan: The value of CT images in the course of the disease. Clin Imaging. 2020;63:7-9.
  • 28. Hejazi ME, Malek Mahdavi A, Navarbaf Z, et al. Relationship between chest CT scan findings with SOFA score, CRP, comorbidity, and mortality in ICU patients with COVID-19. Int J Clin Pract. 2021;75:e14869.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Romatoloji ve Artrit
Bölüm Makaleler
Yazarlar

Emine Uslu Yurteri 0000-0002-4717-3000

Proje Numarası -
Yayımlanma Tarihi 18 Ekim 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 75 Sayı: 3

Kaynak Göster

APA Uslu Yurteri, E. (2022). The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 75(3), 400-405. https://doi.org/10.4274/atfm.galenos.2022.49354
AMA Uslu Yurteri E. The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. Ekim 2022;75(3):400-405. doi:10.4274/atfm.galenos.2022.49354
Chicago Uslu Yurteri, Emine. “The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75, sy. 3 (Ekim 2022): 400-405. https://doi.org/10.4274/atfm.galenos.2022.49354.
EndNote Uslu Yurteri E (01 Ekim 2022) The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75 3 400–405.
IEEE E. Uslu Yurteri, “The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 75, sy. 3, ss. 400–405, 2022, doi: 10.4274/atfm.galenos.2022.49354.
ISNAD Uslu Yurteri, Emine. “The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75/3 (Ekim 2022), 400-405. https://doi.org/10.4274/atfm.galenos.2022.49354.
JAMA Uslu Yurteri E. The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75:400–405.
MLA Uslu Yurteri, Emine. “The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 75, sy. 3, 2022, ss. 400-5, doi:10.4274/atfm.galenos.2022.49354.
Vancouver Uslu Yurteri E. The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75(3):400-5.
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