Evidence map›Paper›PMID 35912711›Full record

Trial reportCardiology journal2022

Ion channel inhibition with amiodarone or verapamil in symptomatic hospitalized nonintensive-care COVID-19 patients: The ReCOVery-SIRIO randomized trial.

Eliano P Navarese, Przemysław Podhajski, Felicita Andreotti, Giuseppe La Torre, Robert Gajda, Adrian Radziwanowski, Małgorzata Nowicka, Paweł Bukowski, Jacek Gajda, Maciej Omyła and 13 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Cardiology journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 8 institutions in 5 countries.

Eliano P NavareseFaculty of Medicine, University of Alberta, Edmonton, Canada. elianonavarese@gmail.com.
Przemysław PodhajskiInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Felicita AndreottiFondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy.
Giuseppe La TorreDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Robert GajdaDepartment of Infectious Diseases, District Hospital, Pultusk, Poland.
Adrian RadziwanowskiInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Małgorzata NowickaInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Paweł BukowskiDepartment of Infectious Diseases, District Hospital, Pultusk, Poland.
Jacek GajdaDepartment of Infectious Diseases, District Hospital, Pultusk, Poland.
Maciej OmyłaDepartment of Infectious Diseases, District Hospital, Pultusk, Poland.
Piotr LackowskiInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Maciej PiaseckiInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Małgorzata JasiewiczInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Paweł SzymańskiDepartment of Infectious Diseases, Regional Hospital, Grudziadz, Poland.
Łukasz PietrzykowskiInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Piotr MichalskiInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Aldona KubicaDepartment of Health Promotion, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Poland.
Iwona UrbanowiczInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Nicola OrsiniDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Max ConteAnesthesia and Intensive Care Unit, Ospedale Bari Sud Di Venere, Bari, Italy.
Jarosław PinkasCenter of Postgraduate Medical Education, School of Public Health, Warsaw, Poland.
Marc A BrouwerDepartment of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands.
Jacek KubicaInterventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.
Nicolaus Copernicus University · PLIstituti di Ricovero e Cura a Carattere Scientifico · ITKarolinska Institutet · SEMedical University of Lodz · PLPostgraduate School of Molecular Medicine · PLRadboud University Medical Center · NLSapienza University of Rome · ITUniversity of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIon channel inhibition may offer protection against coronavirus disease 2019 (COVID-19). Inflammation and reduced platelet count occur during COVID-19 but precise quantification of risk thresholds is unclear. The Recov ery-SIRIO study aimed to assess clinical effects of amiodarone and verapamil and to relate patient phenotypes to outcomes.

methodsRECOVERY-SIRIO is a multicenter open-label 1:1:1 investigator-initiated randomized trial with blinded event adjudication. A sample of 804 symptomatic hospitalized nonintensive-care COVID-19 patients, follow-up for 28 days was initially planned.

resultsThe trial was stopped when a total of 215 patients had been randomized to amiodarone (n = 71), verapamil (n = 72) or standard care alone (n = 72). At 15 days, the hazard ratio (hazard ratio [HR], 95% confidence interval [CI]) for clinical improvement was 0.77 (0.52-1.14) with amiodarone and 0.97 (0.81-1.17) with verapamil as compared to usual care. Clinically relevant associations were found between mortality or lack of clinical improvement and higher peak C-reactive protein (CRP) levels or nadir platelet count at 7, 10 and 15 days. Mortality rate increased by 73% every 5 mg/dL increment in peak CRP (HR 1.73, 95% CI 1.27-2.37) and was two-fold higher for every decrement of 100 units in nadir platelet count (HR 2.19, 95% CI 1.37-3.51). By cluster analysis, thresholds of 5 mg/dL for peak CRP and 187 × 103/mcL for nadir platelet count identified the phenogroup at greatest risk of dying.

conclusionsIn this randomized trial, neither amiodarone nor verapamil were found to significantly accelerate short-term clinical improvement. Peak CRP and nadir platelet counts were associated with increased mortality both in isolation and by cluster analysis.

Indexed as

AmiodaroneCOVID-19CarbidopaC-Reactive ProteinDrug CombinationsHumansIon ChannelsLevodopaSARS-CoV-2VerapamilAmiodaroneCarbidopaC-Reactive ProteinDrug CombinationsIon ChannelsLevodopasirioVerapamilamiodaroneCOVID-19ion-channel inhibitionrandomized trialverapamil

Identifiers

PMID35912711
PMCPMC9550324
OpenAlexW4289205799

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.