Predictors of Mortality in Severe and Critical COVID-19 Patients Receiving High Dose Intravenous Anakinra

Authors : Murat BEKTAŞ, Muhammed İkbal KILIÇ

Pages : 7-16

Doi:10.58854/jicm.1247409

View : 13 | Download : 10

Publication Date : 2023-03-29

Article Type : Research Paper

Abstract :Objective: In this study, we aim to evaluate the predictive factors associated with mortality in patients with severe and critical COVID-19 receiving high dose intravenous anakinra. Methods: This is an observational retrospective study was conducted at a tertiary referral center between 01.09.2021 and 01.02.2022 in Turkey. COVID-19 disease severity was evaluated according to National Institute of Health insert ignore into journalissuearticles values(NIH); severity scale. Inflammatory state of the patients was calculated according to COVID hyperinflammatory syndrome insert ignore into journalissuearticles values(cHIS); score. Clinical insert ignore into journalissuearticles values(patients characteristics, disease severity, inflammatory state); and laboratory parameters such as lymphocyte count, CRP, LDH, ferritin and d-dimer levels were compared in patients had mortality and those had not. Results: Data of 148 patients insert ignore into journalissuearticles values(n=78; 53% male); were analyzed. Mean±standard deviation insert ignore into journalissuearticles values(SD); patient age was 66.8±17 years and median insert ignore into journalissuearticles values(interquartile of range; IQR); duration of hospitalization was 11 insert ignore into journalissuearticles values(12); days. In this cohort, 57 patients insert ignore into journalissuearticles values(38.5%); severe, 91 patients insert ignore into journalissuearticles values(61.5%); had critical disease and mean±SD cHIS score was 3.4±1.2. Overall, 56 patients insert ignore into journalissuearticles values(37.8%); died during the follow-up and ICU admission was in 60 patients insert ignore into journalissuearticles values(40.5%); and intubation was in 54 patients insert ignore into journalissuearticles values(36.5%);. Conclusion: In our study mortality was developed in third of anakinra receiving severe and critical ill COVID-19 patients. Mortality was independently associated with advanced age, critical illness and higher cHIS score reflecting higher inflammatory burden. Furthermore, highest levels of CRP, LDH, ferritin, D-dimer and higher cHIS score predict higher mortality in patients with COVID-19 receiving anakinra.
Keywords : COVİD 19, Anakinra, Sitokin Fırtınası, Hiperinflamasyon, Öngördürücüler