The Factors Affecting the Efficacy of Interleukin-1 Receptor Antagonists in COVID-19 Patients
Abstract
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.
Keywords
COVID-19, Anakinra, Hypertension
Ethical Statement
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.
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