International Journal of Infectious Diseases (Feb 2021)
Anakinra in hospitalized patients with severe COVID-19 pneumonia requiring oxygen therapy: Results of a prospective, open-label, interventional study
- A. Balkhair,
- I. Al-Zakwani,
- M. Al Busaidi,
- A. Al-Khirbash,
- S. Al Mubaihsi,
- H. BaTaher,
- J. Al Aghbari,
- I. Al Busaidi,
- M. Al Kindi,
- S. Baawain,
- A. Al Alawi,
- A. Al Lawati,
- B. Al Rawahi,
- K. Al-Baimani,
- K. Al Zidi,
- N. Elfatih,
- B. Dawud,
- B. John,
- F. Rehman,
- F. Yousif,
- G. Al Khadouri,
- I. Saber,
- J. Lal,
- M. Gargouri,
- M. Al-Ward,
- N. AbuDraz,
- S. Al Ruqeishi,
- S. Kumar,
- W. Abdelmottaleb,
- Z. Al-Naamani,
- Z. Bin Nazar,
- O. Balkhair
Affiliations
- A. Balkhair
- Department of Medicine, Infectious Diseases Unit, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman; Corresponding author.
- I. Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, PO Box 35, Alkoudh 123, Muscat, Oman
- M. Al Busaidi
- Department of Medicine, Intensive Care, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- A. Al-Khirbash
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, PO Box 35, Alkoudh 123, Muscat, Oman
- S. Al Mubaihsi
- Department of Medicine, Pulmonology, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- H. BaTaher
- Department of Medicine, Infectious Diseases Unit, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- J. Al Aghbari
- Department of Medicine, Pulmonology, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- I. Al Busaidi
- Department of Medicine, Infectious Diseases Unit, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- M. Al Kindi
- Department of Microbiology and Immunology, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- S. Baawain
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- A. Al Alawi
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- A. Al Lawati
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- B. Al Rawahi
- Department of Hematology, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- K. Al-Baimani
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- K. Al Zidi
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- N. Elfatih
- Department of Medicine, Pulmonology, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- B. Dawud
- Department of Surgery, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- B. John
- Department of Surgery, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- F. Rehman
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- F. Yousif
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- G. Al Khadouri
- Department of Hematology, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- I. Saber
- Department of Surgery, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- J. Lal
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- M. Gargouri
- Department of Surgery, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- M. Al-Ward
- Department of Surgery, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- N. AbuDraz
- Department of Surgery, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- S. Al Ruqeishi
- Department of Hematology, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- S. Kumar
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- W. Abdelmottaleb
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- Z. Al-Naamani
- Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Alkoudh 123, Muscat, Oman
- Z. Bin Nazar
- Faculty of Biological Sciences, University of Leeds, UK
- O. Balkhair
- Faculty of Biological Sciences, University of Leeds, UK
- Journal volume & issue
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Vol. 103
pp. 288 – 296
Abstract
Objective: The aim of this study was to evaluate the efficacy of anakinra in patients who were admitted to hospital for severe COVID-19 pneumonia requiring oxygen therapy. Methods: A prospective, open-label, interventional study in adults hospitalized with severe COVID-19 pneumonia was conducted. Patients in the interventional arm received subcutaneous anakinra (100 mg twice daily for 3 days, followed by 100 mg daily for 7 days) in addition to standard treatment. Main outcomes were the need for mechanical ventilation and in-hospital death. Secondary outcomes included successful weaning from supplemental oxygen and change in inflammatory biomarkers. Outcomes were compared with those of historical controls who had received standard treatment and supportive care. Results: A total of 69 patients were included: 45 treated with anakinra and 24 historical controls. A need for mechanical ventilation occurred in 14 (31%) of the anakinra-treated group and 18 (75%) of the historical cohort (p < 0.001). In-hospital death occurred in 13 (29%) of the anakinra-treated group and 11 (46%) of the historical cohort (p = 0.082). Successful weaning from supplemental oxygen to ambient air was attained in 25 (63%) of the anakinra-treated group compared with 6 (27%) of the historical cohort (p = 0.008). Patients who received anakinra showed a significant reduction in inflammatory biomarkers. Conclusion: In patients with severe COVID-19 pneumonia and high oxygen requirement, anakinra could represent an effective treatment option and may confer clinical benefit. Trial registration number: ISRCTN74727214.
