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. 2023 Nov;42(11):1383-1387.
doi: 10.1007/s10096-023-04661-2. Epub 2023 Sep 19.

High-dose anakinra in addition to standard of care including corticosteroids in patients with severe COVID-19 treated with non-invasive ventilation

Andrea Mastrangelo #  1   2 , Roberta Monardo #  1   2 , Laura Galli  2 , Alessandro Tomelleri  1   3 , Chiara Tassan Din  2 , Diana Canetti  2 , Emanuela Messina  2 , Monica Guffanti  2 , Anna Danise  2 , Corrado Campochiaro  1   3 , Giulio Cavalli  1   3 , Giacomo Monti  1   4 , Paola Cinque  2 , Paolo Scarpellini  2 , Giovanni Landoni  1   4 , Fabio Ciceri  1   5 , Lorenzo Dagna  1   3 , Antonella Castagna  1   2 , Marco Ripa  6   7
Affiliations

High-dose anakinra in addition to standard of care including corticosteroids in patients with severe COVID-19 treated with non-invasive ventilation

Andrea Mastrangelo et al. Eur J Clin Microbiol Infect Dis. 2023 Nov.

Abstract

Management of COVID-19 patients experiencing persisting respiratory failure despite corticosteroids remains challenging. Data on high-dose intravenous anakinra (HD-ANK) in this context are lacking. We aimed to investigate the impact of HD-ANK on mortality in COVID-19 patients progressing to non-invasive ventilation (NIV) while receiving corticosteroids. We retrospectively analyzed the impact of HD-ANK on 28-day mortality in individuals hospitalized with COVID-19 necessitating NIV after corticosteroid initiation. A total of 256 patients were identified: 146 received standard-of-care only (SOC), and 110 received HD-ANK+SOC. The groups were well-balanced at baseline. In-hospital mortality at 28 days did not differ between the two groups. HD-ANK is not beneficial in patients with severe COVID-19 deteriorating despite corticosteroids.

Keywords: COVID-19; Interleukin 1 receptor antagonist protein; Noninvasive ventilation.

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