Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26731
Title: Immunosuppressive strategies in invasively ventilated ARDS COVID-19 patients.
Austin Authors: Monti, Giacomo;Campochiaro, Corrado;Zangrillo, Alberto;Scandroglio, Anna Mara;Fominskiy, Evgeny;Cavalli, Giulio;Landoni, Giovanni;Beretta, Luigi;Mucci, Milena;Calabró, Maria Grazia;Pieri, Marina;Nardelli, Pasquale;Sartorelli, Marianna;Baiardo Redaelli, Martina;Morselli, Federica;Serpa Neto, Ary ;Bellomo, Rinaldo ;Dagna, Lorenzo
Affiliation: Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy -. Vita-Salute San Raffaele University, Milan, Italy
Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Vita Salute San Raffaele University, Milan, Italy
Faculty of Medicine, University of Melbourne, Melbourne, Australia
Intensive Care
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
Issue Date: Aug-2021
Date: 2021-06-08
Publication information: Minerva Anestesiologica 2021; 87(8): 891-902
Abstract: COVID-19 is associated with elevated levels of inflammatory cytokines. We present the characteristics and outcomes of patients treated in the intensive care unit (ICU) with immunosuppressive drugs, either tocilizumab or anakinra compared with controls. A Single-center observational prospective study on ICU invasively ventilated COVID-19 patients. The primary outcome was the clinical improvement at day 28. A Bayesian framework was employed and all analyses were adjusted for confounders. Sixty-one consecutive invasively ventilated patients were included, nine (14∙7%) received tocilizumab and 15 (24∙6%) received anakinra. Over the first seven days, tocilizumab was associated with a greater decrease in C-reactive protein (p<0∙001). After adjusting for confounders, the probability of clinical improvement at day 28 compared to control was 7∙6% (OR, 0∙36 [95% CrI, 0∙09-1∙46]) for tocilizumab and 40∙9% (OR, 0∙89 [95% CrI, 0∙32-2∙43]) for anakinra. At day 28, the probability of being in a better clinical category was 2∙5% (OR, 2∙98 [95% CrI, 1∙00-8∙88]) for tocilizumab, and 49∙5% (OR, 1∙00 [95% CrI, 0∙42-2∙42]) for anakinra. In invasively ventilated COVID-19 patients, treatment with anakinra was associated with a higher probability of clinical improvement compared to tocilizumab; however, treatment with either drug did not result in clinically meaningful improvements compared with controls.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26731
DOI: 10.23736/S0375-9393.21.15339-8
Journal: Minerva Anestesiologica
PubMed URL: 34102804
Type: Journal Article
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