Trial reportJournal of internal medicine2021
Cyclosporine A plus low-dose steroid treatment in COVID-19 improves clinical outcomes in patients with moderate to severe disease: A pilot study.
Trial report in Journal of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 5 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Broad-Spectrum Antiviral Activity of Cyclophilin Inhibitors Against Coronaviruses: A Systematic Review.International journal of molecular sciences · 2025Pooled it
- The pandemic is gone but its consequences are here to stay: avascular necrosis following corticosteroids administration for severe COVID-19.Journal of orthopaedic surgery and research · 2024Pooled it
- Promises and Pitfalls of Calcineurin Inhibitors in COVID-19: A Systematic Review and Meta-analysis of Controlled Trials.Current medicinal chemistry · 2024Pooled it
- The association between severe or death COVID-19 and solid organ transplantation: A systematic review and meta-analysis.Transplantation reviews (Orlando, Fla.) · 2021Pooled it
- Immunomodulatory therapies for SARS-CoV-2 infection: a systematic literature review to inform EULAR points to consider.Annals of the rheumatic diseases · 2021Pooled it
- Effectiveness and safety of cyclosporine A in moderate to severe COVID-19: a randomized, open-label trial.Scientific reports · 2026Trial
- Cyclosporine A in hospitalized COVID-19 pneumonia patients to prevent the development of interstitial lung disease: a pilot randomized clinical trial.Scientific reports · 2024Trial
- Knowledge structure and emerging trends on osteonecrosis of the femoral head: a bibliometric and visualized study.Journal of orthopaedic surgery and research · 2022Trial
- Trial
- Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial.International immunopharmacology · 2021Trial
- Cyclosporine A plus low-dose steroid treatment in COVID-19 improves clinical outcomes in patients with moderate to severe disease: A pilot study.Journal of internal medicine · 2021Trial
- Impact of COVID-19 on liver transplant recipients: A nationwide cohort study evaluating hospitalization, transplant rejection, and inpatient mortality.World journal of transplantation · 2024Article
- Clinical development of antivirals against SARS-CoV-2 and its variants.Current research in microbial sciences · 2024Review
- Efficacy and safety of calcineurin inhibitors (CNIs) for septic patients in ICU: a cohort study from MIMIC database.Frontiers in pharmacology · 2024Article
- Voclosporin and the Antiviral Effect Against SARS-CoV-2 in Immunocompromised Kidney Patients.Kidney international reports · 2023Article
- A case of hemophagocytic lymphohistiocytosis in a hemodialysis patient with coronavirus disease 2019.CEN case reports · 2023Article
- COVID-19 in Patients with Pre-Existing Interstitial Lung Disease: Potential Value of a Steroid-Based Treatment Strategy.Journal of clinical medicine · 2023Article
- Protein structure-based in-silico approaches to drug discovery: Guide to COVID-19 therapeutics.Molecular aspects of medicine · 2023Review
- COVID-19 in patients with liver disease and liver transplant: clinical implications, prevention, and management.Therapeutic advances in gastroenterology · 2023Review
- Psoriasis comorbidity management in the COVID era: a pressing challenge.Frontiers in microbiology · 2023Review
Corrections and comments
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Authors and funding
24 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCOVID-19 pandemic causes high global morbidity and mortality and better medical treatments to reduce mortality are needed.
objectiveTo determine the added benefit of cyclosporine A (CsA), to low-dose steroid treatment, in patients with COVID-19.
methodsOpen-label, non randomized pilot study of patients with confirmed infection of SARS-CoV-2 hospitalized from April to May 2020 at a single centre in Puebla, Mexico. Patients were assigned to receive either steroids or CsA plus steroids. Pneumonia severity was assessed by clinical, laboratory, and lung tomography. The death rate was evaluated at 28 days.
resultsA total of 209 adult patients were studied, 105 received CsA plus steroids (age 55.3 ± 13.3; 69% men), and 104 steroids alone (age 54.06 ± 13.8; 61% men). All patients received clarithromycin, enoxaparin and methylprednisolone or prednisone up to 10 days. Patient's death was associated with hypertension (RR = 3.5) and diabetes (RR = 2.3). Mortality was 22 and 35% for CsA and control groups (P = 0.02), respectively, for all patients, and 24 and 48.5% for patients with moderate to severe disease (P = 0.001). Higher cumulative clinical improvement was seen for the CsA group (Nelson Aalen curve, P = 0.001, log-rank test) in moderate to severe patients. The Cox proportional hazard analysis showed the highest HR improvement value of 2.15 (1.39-3.34, 95%CI, P = 0.0005) for CsA treatment in moderate to severe patients, and HR = 1.95 (1.35-2.83, 95%CI, P = 0.0003) for all patients.
conclusionCsA used as an adjuvant to steroid treatment for COVID-19 patients showed to improve outcomes and reduce mortality, mainly in those with moderate to severe disease. Further investigation through controlled clinical trials is warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.