ÖZET

Amaç:

Koronavirüs hastalığı-2019 (COVID-19) tüm dünyaya hızla yayılmaktadır. İnterlökin-1 (IL-1), akciğer hasarına neden olan SARS-CoV-2 ile bağlantılı proinflamatuar bir sitokindir. Anakinra, bir IL-1 reseptör antagonistidir. Bu çalışmada anakinra tedavisi sonrası hayatta kalan COVID-19 hastalarının özelliklerini açıklamaya hedefledik.

Gereç ve Yöntem:

Pulse steroid tedavisine yanıt vermeyen ve 8 mg/kg Anakinra verilen 44 hasta çalışmaya dahil edildi. Anakinra sonrası sağ kalan ve yaşamayan hastaların klinik, laboratuvar ve görüntüleme [toraks bilgisayarlı tomografi (BT)] bulguları karşılaştırıldı.

Bulgular:

Hastaların çoğu erkekti (%81,8), medyan takip süresi 19,5 (IQR 15.5) gündü. Hastaların %40,9’unda ölüm meydana geldi. Yaşamayan grupta ortanca yaş daha yüksek (p<0,001) ve diabetes mellitus daha yaygındı (p<0,034). Çok değişkenli cox regresyon analizinde, anakinra ile tedavi edilen COVID-19 hastalarında altta yatan hipertansiyon varlığı (p=0,017) ve hastaneye ilk başvurusundaki akciğer bilgisayarlı tomografisinde saf buzlu cam görünümünün (p=0,04) bağımsız mortalite risk faktörleri olduğu bulundu.

Sonuç:

COVID-19 hastalarında hipertansiyon varlığı ve hastaneye ilk başvuruda akciğer BT’sinde saf buzlu cam varlığı anakinra tedavisine yanıtı azaltabilecek durumlardır. Bu bulgunun geçerliliğini göstermek için daha büyük hasta popülasyonları ile ileriye dönük çalışmalara ihtiyaç vardır.

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COVID-19 Hastalarında İnterlökin-1 Reseptör Antagonistlerinin Etkinliğini Etkileyen Faktörler

ÖZET

References