학술논문

Patients diagnosed with COVID-19 and treated with anakinra: a real-world study in the USA.
Document Type
Article
Source
Clinical & Experimental Immunology. Feb2022, Vol. 207 Issue 2, p218-226. 9p.
Subject
*COVID-19
*MYOCARDIAL infarction
*ANAKINRA
*CORONAVIRUS diseases
*INTERLEUKIN-1 receptor antagonist protein
*INTENSIVE care patients
Language
ISSN
0009-9104
Abstract
Anakinra, a recombinant, non-glycosylated human interleukin (IL)-1 receptor antagonist, has been used in real-world clinical practice to manage hyperinflammation in coronavirus disease 2019 (COVID-19). This retrospective, observational study analyses US hospital inpatient data of patients diagnosed with moderate/severe COVID-19 and treated with anakinra between 1 April and 31 August 2020. Of the 119 patients included in the analysis, 63.9% were male, 48.6% were of black ethnicity, and the mean (standard deviation [SD]) age was 64.7 (12.5) years. Mean (SD) time from hospital admission to anakinra initiation was 7.3 (6.1) days. Following anakinra initiation, 73.1% of patients received antibiotics, 55.5% received antithrombotics, and 91.0% received corticosteroids. Overall, 64.7% of patients required intensive care unit (ICU) admittance, and 28.6% received mechanical ventilation following admission. Patients who did not require ICU admittance or who were discharged alive experienced a significantly shorter time between hospital admission and receiving anakinra treatment compared with those admitted to the ICU (5 vs. 8 days; P = 0.002) or those who died in hospital (6 vs. 9 days; P = 0.01). Patients with myocardial infarction or renal conditions were six times (P < 0.01) and three times (P = 0.01), respectively, more likely to die in hospital than be discharged alive. A longer time from hospital admission until anakinra treatment was associated with significantly higher mortality (P = 0.01). Findings from this real-world study suggest that a shorter time from hospital admission to anakinra treatment is associated with significantly lower ICU admissions and mortality among patients with moderate/severe COVID-19. Despite the growing clinical evidence demonstrating a benefit of anakinra in patients with COVID-19, there is a paucity of evidence in the real-world clinical setting. This retrospective, observational study analyses US hospital inpatient data of patients diagnosed with moderate/severe COVID-19 and treated with anakinra. The analyses found that a shorter time from hospital admission to anakinra treatment is associated with significantly lower ICU admissions and mortality. [ABSTRACT FROM AUTHOR]