q7jvosgq

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?:abstract	Introduction The management of pneumonia caused by SARS-CoV-2 should rely on early recognition of the risk for progression to severe respiratory failure (SRF) and its prevention. We investigated if early suPAR (soluble urokinase plasminogen activator receptor)-guided anakinra treatment could prevent COVID-19-assocated SRF. Methods In this open-label prospective trial, 130 patients admitted with SARS-CoV-2 pneumonia SARS-CoV-2 and suPAR levels [≥]6 g/l were assigned to subcutaneous anakinra 100mg once daily for 10 days. The primary outcome was the incidence of SRF at day 14. Secondary outcomes were 30-day mortality, changes in sequential organ failure assessment (SOFA) score, of cytokine-stimulation pattern and of circulating inflammatory mediators. Equal number of propensity score-matched comparators for comorbidities, severity on admission and standard-of care (SOC) were studied. Results The incidence of SRF was 22.3% (95% CI, 16.0-30.2%) among anakinra-treated patients and 59.2% (95% CI, 50.6-67.3%; P: 4.6 x 10-8) among SOC comparators (hazard ratio, 0.30; 95%CI, 0.20-0.46). 30-day mortality was 11.5% (95% CI, 7.1-18.2%) and 22.3% (95% CI, 16.0-30.2%) respectively (hazard ratio 0.49; 95% CI 0.25-0.97%; P: 0.041). Anakinra treatment was associated with decrease in SOFA score and in circulating interleukin (IL)-6, sCD163 and sIL2-R; the serum IL-10/IL-6 ratio on day 7 was inversely associated with the change in SOFA score. Duration of stay at the intensive care unit and at hospital was shortened compared to the SOC group; the cost of hospitalization was decreased. Conclusions Early suPAR-guided anakinra treatment is associated with decrease of the risk for SRF and restoration of the pro- /anti-inflammatory balance.
is ?:annotates of	<https://research.tib.eu/covid-19/entity/q7jvosgq_hasAnnotation_C0003209> <https://research.tib.eu/covid-19/entity/q7jvosgq_hasAnnotation_C0027627> <https://research.tib.eu/covid-19/entity/q7jvosgq_hasAnnotation_C0243042> <https://research.tib.eu/covid-19/entity/q7jvosgq_hasAnnotation_C5203676>
?:creator	<https://research.tib.eu/covid-19/entity/Kyriazopoulou%2C_E.%3B_Panagopoulos%2C_P.%3B_Metallidis%2C_S.%3B_Dalekos%2C_G.%3B_Poulakou%2C_G.%3B_Gatselis%2C_N.%3B_Karakike%2C_E.%3B_Saridaki%2C_M.%3B_Loli%2C_G.%3B_Stefos%2C_A.%3B_Prasianaki%2C_D.%3B_Georgiadou%2C_S.%3B_Tsachouridou%2C_O.%3B_Petrakis%2C_V.%3B_Tsiakos%2C_K.%3B_Kosmidou%2C_M.%3B_Lygoura%2C_V.%3B_Dareioti%2C_M.%3B_Milionis%2C_H.%3B_Papanikolaou%2C_I._C.%3B_Akinosoglou%2C_K.%3B_Myrodia%2C_D.-M.%3B_Gravani%2C_A.%3B_Stamou%2C_A.%3B_Gkavogianni%2C_T.%3B_Katrini%2C_K.%3B_Marantos%2C_T.%3B_Trontzas%2C_I._P.%3B_Syrigos%2C_K.%3B_Chatzis%2C_L.%3B_Chatzis%2C_S.%3B_Vechlidis%2C_N.%3B_Avgoustou%2C_C.%3B_Chalvatzis%2C_S.%3B_Kyprianou%2C_M.%3B_van_der_Meer%2C_J._W.%3B_eugen-olsen%2C_j.%3B_Netea%2C_M.%3B_Giamarellos-Bourboulis%2C_E.>
?:doi	10.1101/2020.10.28.20217455
?:doi	<https://research.tib.eu/covid-19/entity/10.1101/2020.10.28.20217455>
?:license	medrxiv
?:pdf_json_files	document_parses/pdf_json/3226762aea7747fa38c998ade20e1f15d5116ce9.json
?:publication_isRelatedTo_Disease	<https://research.tib.eu/covid-19/entity/COVID-19>
is ?:relation_isRelatedTo_publication of	<https://research.tib.eu/covid-19/entity/q7jvosgq_HAS_C0245109_PREVENTS_C1145670> <https://research.tib.eu/covid-19/entity/q7jvosgq_HAS_C1145670_COEXISTS_WITH_C5203670> <https://research.tib.eu/covid-19/entity/q7jvosgq_HAS_C5203676_CAUSES_C0032285>
?:sha_id	<https://research.tib.eu/covid-19/entity/3226762aea7747fa38c998ade20e1f15d5116ce9>
?:source	MedRxiv; WHO
?:title	Anakinra To Prevent Respiratory Failure In COVID-19
?:type	<https://research.tib.eu/covid-19/vocab/Publication>
?:year	2020-10-29

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?:abstract

Introduction The management of pneumonia caused by SARS-CoV-2 should rely on early recognition of the risk for progression to severe respiratory failure (SRF) and its prevention. We investigated if early suPAR (soluble urokinase plasminogen activator receptor)-guided anakinra treatment could prevent COVID-19-assocated SRF. Methods In this open-label prospective trial, 130 patients admitted with SARS-CoV-2 pneumonia SARS-CoV-2 and suPAR levels [≥]6 g/l were assigned to subcutaneous anakinra 100mg once daily for 10 days. The primary outcome was the incidence of SRF at day 14. Secondary outcomes were 30-day mortality, changes in sequential organ failure assessment (SOFA) score, of cytokine-stimulation pattern and of circulating inflammatory mediators. Equal number of propensity score-matched comparators for comorbidities, severity on admission and standard-of care (SOC) were studied. Results The incidence of SRF was 22.3% (95% CI, 16.0-30.2%) among anakinra-treated patients and 59.2% (95% CI, 50.6-67.3%; P: 4.6 x 10-8) among SOC comparators (hazard ratio, 0.30; 95%CI, 0.20-0.46). 30-day mortality was 11.5% (95% CI, 7.1-18.2%) and 22.3% (95% CI, 16.0-30.2%) respectively (hazard ratio 0.49; 95% CI 0.25-0.97%; P: 0.041). Anakinra treatment was associated with decrease in SOFA score and in circulating interleukin (IL)-6, sCD163 and sIL2-R; the serum IL-10/IL-6 ratio on day 7 was inversely associated with the change in SOFA score. Duration of stay at the intensive care unit and at hospital was shortened compared to the SOC group; the cost of hospitalization was decreased. Conclusions Early suPAR-guided anakinra treatment is associated with decrease of the risk for SRF and restoration of the pro- /anti-inflammatory balance.

is ?:annotates of