Evidence map›Paper›PMID 38511750›Full record

ArticleRevista da Associacao Medica Brasileira (1992)2024

Use of high-dose steroid therapy: addition of anakinra in the treatment of severe COVID-19.

Kadir Gorkem Guclu, Ceyda Geyiktepe-Guclu, Osman Faruk Bayramlar, Gulsah Tuncer, Mehtap Aydin

Open access · diamondAbstract read
In one paragraph

Article in Revista da Associacao Medica Brasileira (1992), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 43% 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

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
  2. 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

5 authors at 4 institutions in 1 country.

Kadir Gorkem GucluUmraniye Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology - İstanbul, Turkey.ORCID http://orcid.org/0000-0002-2682-7570
Ceyda Geyiktepe-GucluHaseki Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology - İstanbul, Turkey.ORCID http://orcid.org/0009-0008-7561-6842
Osman Faruk BayramlarTurkish Ministry of Health - Istanbul Health Directorate, Bakırköy District Health Directorate - İstanbul, Turkey.ORCID http://orcid.org/0000-0001-7311-3258
Gulsah TuncerBilecik Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology - Bilecik, Turkey.ORCID http://orcid.org/0000-0002-9841-9146
Mehtap AydinUmraniye Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology - İstanbul, Turkey.ORCID http://orcid.org/0000-0003-4044-9366
Ümraniye Eğitim ve Araştırma Hastanesi · TRBilecik Şeyh Edebali Üniversitesi · TRHaseki Eğitim ve Araştırma Hastanesi · TRMinistry of Health · TR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to compare the clinical effects of the addition of anakinra to high-dose steroid therapy in COVID-19 patients with macrophage activation syndrome.

methodsThis was a single-center retrospective study conducted in Ümraniye Training and Research Hospital between March 11, 2020, and April 28, 2021. Patients receiving only high-dose steroid or anakinra+steroid were enrolled. The first day of anakinra was considered as day 0. Laboratory values and oxygen requirements were followed up for 7 days. Patients were divided into two groups: 66 patients in the high-dose steroid group and 67 patients in the anakinra+steroid group. The primary outcome was 28-day mortality.

resultsAfter treatment, a significant decrease in ferritin levels was detected only in the anakinra+steroid group (p=0.001). In both groups, there were significant changes in lymphocytes, C-reactive protein, lactate dehydrogenase, and fibrinogen levels during the 7-day follow-up. Changes in oxygen status according to the World Health Organization clinical scale on day 3 and day 7 between high-dose steroid and anakinra+steroid groups were similar (p=0.976). Complications were higher in the anakinra+steroid group than in the steroid group (26% vs. 12%, p=0.03). The rates of 28-day mortality were 57% in the anakinra+steroid group and 42% in the high-dose steroid group (p=0.48). In multivariate regression, anakinra did not affect 28-day mortality (p=0.67).

conclusionThe addition of anakinra to steroid treatment resulted in a significant decrease in biochemical parameters. However, no significant difference was observed in the oxygen status between the groups. The addition of anakinra to steroid treatment did not decrease mortality. Clinicians should be aware of the complications of anti-inflammatory therapies.

Indexed as

COVID-19Anti-Inflammatory AgentsHumansInterleukin 1 Receptor Antagonist ProteinOxygenRetrospective StudiesAnti-Inflammatory AgentsInterleukin 1 Receptor Antagonist ProteinOxygen

Identifiers

PMID38511750
PMCPMC10941869
OpenAlexW4392856964

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Registered trials

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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.