High Dose Intravenous Anakinra Treatment is Safe and Effective in Severe and Critical COVID-19 Patients: A Propensity Score Matched Study in a Single Center

Abstract

Background: In COVID-19 severe disease course such as need of intensive care unit (ICU) as well as development of mortality is mainly due to cytokine storm. In this study, we aimed to evaluate the high dose intravenous anakinra treatment response and outcome in patients with severe and critically ill COVID-19 compared to standard of care. Method : This retrospective observational study was carried out at a tertiary referral center. The study population consisted of two groups as follows; the patients receiving high dose intravenous anakinra (anakinra group) between 01.09.2021 and 01.02.2022 and the patients treated with standard of care (SoC, control group) as historical control group who were hospitalized between 01.07.2021 and 01.09.2021. Results:After the propensity score 1:1 matching 79 patients in anakinra and 79 patients in SoC matched and included into the analysis. Mean±SD patient age was 67.4±16.7 and 67.1±16.3 years in anakinra and SoC group, respectively (p=0.9). Male gender was 38 (48.7 %) in anakinra and 36 (46.2 %) SoC (p=0.8). Overall, ICU admission was in 14.1 % (n=11) and 30.8 % (n=24) (p=0.013; OR: 6.2), intubation in 12.8 % (n=10) and 16.7 % (n=13) patients (p=0.5), 14.1 % (n=11) and 32.1 % (n=25) patients died in anakinra and control group, respectively (p=0.008; OR: 7.1) Conclusion : In our study mortality was lower in patients receiving anakinra compared to SoC. Intravenous high dose anakinra is safe and effective treatment in patients with severe and critical COVID-19.

Intravenous High-dose Anakinra Drops Venous Thrombosis and Myocardial Infarction in Severe and Critical COVID-19 Patients: A Propensity Score Matched Study

“…Moreover, the fact that higher values of peak levels of CRP, d-dimer, LDH, and ferritin than those baseline levels emphasize the crucial role of hyperin ammation in the development of thrombotic events. This nding was also consistent with our previous results regarding the close association between peak levels of these laboratory tests and poor outcomes [13].…”

“…In our study, the lower frequency of PTE in the anakinra group was a remarkable nding even though the anakinra group had more severe disease before propensity score matching [37]. This nding persists after the PS matching procedure.…”

“…Daily dose adjustment of anakinra may allow early intervention of the cytokine storm according to daily clinical status, as well as withdrawing the drug in case of infection or other complications. Additionally, intravenous high-dose anakinra treatment reduced mortality in our previous study [13].…”

“…This retrospective observational study, which includes secondary analysis of our previous study [13], was conducted at a tertiary referral center in Aksaray, Turkey. Diagnosis of COVID-19 was performed by typical computer tomography (CT) ndings in addition to clinical signs and symptoms and con rmed with positive polymerase chain reaction (PCR).…”

“…The item of fever was removed due to its lower frequency (<%10) in both arms. Therefore, the maximum score of the new version of the cHIS score was 5 points (modi ed cHIS [mcHIS] score) was calculated in both groups [13].…”