Evidence map›Paper›PMID 36445625›Full record

Trial reportCardiovascular drugs and therapy2024

Effect of Remote Ischaemic Conditioning on the Inflammatory Cytokine Cascade of COVID-19 (RIC in COVID-19): a Randomized Controlled Trial.

Kishal Lukhna, Helison R P do Carmo, Alejandro Rossell Castillo, Sean M Davidson, Hayli Geffen, Sara Giesz, Pelin Golforoush, Ticiane Gonçalez Bovi, Diana Gorag, Alan Salama and 7 more

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Cardiovascular drugs and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04699227 (CAN REMOTE ISCHAEMIC CONDITIONING REDUCE INFLAMMATORY MARKERS IN COVID-19 PATIENTS - A MULTI-SITE, RANDOMISED PILOT STUDY), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 42% 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.

NCT04699227 nacompletednot on this map

Can remote ischaemic conditioning reduce inflammatory markers in covid-19 patients - a multi-site, randomised pilot study

TypeinterventionalSponsorDerek YellonRan2021 to 2021Enrolled40ConditionsCovid19, IschemiaArmsCuff application with inflation, Sham inflation
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
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

17 authors at 3 institutions in 3 countries.

Kishal LukhnaDivision of Cardiology, Faculty of Health Sciences, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Helison R P do CarmoAtherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil.
Alejandro Rossell CastilloAtherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil.
Sean M DavidsonThe Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK.
Hayli GeffenDivision of Cardiology, Faculty of Health Sciences, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Sara GieszThe Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK.
Pelin GolforoushThe Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK.
Ticiane Gonçalez BoviAtherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil.
Diana GoragAtherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil.
Alan SalamaCape Heart Institute, University of Cape Town, Cape Town, South Africa.
Aqeela ImamdinCape Heart Institute, University of Cape Town, Cape Town, South Africa.
Siavash KalkhoranThe Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK.
Sandrine LecourCape Heart Institute, University of Cape Town, Cape Town, South Africa.
Mauricio W PerroudAtherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil.
Mpiko NtsekheDivision of Cardiology, Faculty of Health Sciences, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Andrei C SpositoAtherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil.
Derek M YellonThe Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK. d.yellon@ucl.ac.uk.ORCID 0000-0001-7791-9320
Universidade Estadual de Campinas (UNICAMP) · BRUniversity of Cape Town · ZAUniversity College London · GB

Funding

Brazilian National Research Council 304257/2021-4Cardiovascular Medical Research and Education FundEdith Sorell FellowshipJohn T. Reid Charitable TrustsSAMRC Self-Initiated Research Grant.the Fundação de Apoio a Pesquisa do Estado de São Paulo (FAPESP)The Mancherje-Potash FoundationThompson Family FoundationUCT Start-up Emerging Research Award
6 · The paper itself

Abstract

purposePatients hospitalized with COVID-19 may develop a hyperinflammatory, dysregulated cytokine "storm" that rapidly progresses to acute respiratory distress syndrome, multiple organ dysfunction, and even death. Remote ischaemic conditioning (RIC) has elicited anti-inflammatory and cytoprotective benefits by reducing cytokines following sepsis in animal studies. Therefore, we investigated whether RIC would mitigate the inflammatory cytokine cascade induced by COVID-19.

methodsWe conducted a prospective, multicentre, randomized, sham-controlled, single-blind trial in Brazil and South Africa. Non-critically ill adult patients with COVID-19 pneumonia were randomly allocated (1:1) to receive either RIC (intermittent ischaemia/reperfusion applied through four 5-min cycles of inflation (20 mmHg above systolic blood pressure) and deflation of an automated blood-pressure cuff) or sham for approximately 15 days. Serum was collected following RIC/sham administration and analyzed for inflammatory cytokines using flow cytometry. The endpoint was the change in serum cytokine concentrations. Participants were followed for 30 days.

resultsEighty randomized participants (40 RIC and 40 sham) completed the trial. Baseline characteristics according to trial intervention were overall balanced. Despite downward trajectories of all cytokines across hospitalization, we observed no substantial changes in cytokine concentrations after successive days of RIC. Time to clinical improvement was similar in both groups (HR 1.66; 95% CI, 0.938-2.948, p 0.08). Overall RIC did not demonstrate a significant impact on the composite outcome of all-cause death or clinical deterioration (HR 1.19; 95% CI, 0.616-2.295, p = 0.61).

conclusionRIC did not reduce the hypercytokinaemia induced by COVID-19 or prevent clinical deterioration to critical care.

trial registrationClinicalTrials.gov Identifier: NCT04699227.

Indexed as

COVID-19CytokinesIschemic PreconditioningAdultAgedBrazilCytokine Release SyndromeFemaleHumansMaleMiddle AgedProspective StudiesSARS-CoV-2Single-Blind MethodSouth AfricaTreatment OutcomeCytokinesCOVID-19Cytokine stormImmunosuppressionInflammatory cascadeRandomized controlled trialRemote ischaemic conditioning

Identifiers

PMID36445625
PMCPMC9707178
OpenAlexW4310229345

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.