Evidence map›Paper›PMID 39827089›Full record

Observational studyRespiratory research2025

Neutrophil elastase inhibitor (Sivelestat) in the treatment of acute respiratory distress syndrome induced by COVID-19: a multicenter retrospective cohort study.

Yuting Li, Jianjun Zhao, Jiahui Wei, Yanhong Zhang, Haitao Zhang, Ying Li, Ting Liao, Yang Hu, Bo Yuan, Xinmei Zhang and 13 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

12 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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.

Yuting LiDepartment of Critical Care Medicine, The First Hospital of Jilin University, Changchun, 130021, Jilin, China.
Jianjun ZhaoRespiratory Intensive Care Unit, Sino-Japanese Friendship Hospital of Jilin Province, Changchun, 130033, Jilin, China.
Jiahui WeiRespiratory Intensive Care Unit, Sino-Japanese Friendship Hospital of Jilin Province, Changchun, 130033, Jilin, China.
Yanhong ZhangEmergency Department, Jilin Province People's Hospital, Changchun, 130021, Jilin, China.
Haitao ZhangDepartment of Critical Care Medicine, Jilin Province People's Hospital, Changchun, 130021, Jilin, China.
Ying LiDepartment of Critical Care Medicine, Tonghua People's Hospital, Tonghua, 134001, Jilin, China.
Ting LiaoDepartment of Critical Care Medicine, Tonghua People's Hospital, Tonghua, 134001, Jilin, China.
Yang HuDepartment of Critical Care Medicine, The Third Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, 130118, Jilin, China.
Bo YuanRespiratory Intensive Care Unit, Siping City Central People's Hospital, Siping, 136099, Jilin, China.
Xinmei ZhangDepartment of Critical Care Medicine, Siping City Central People's Hospital, Siping, 136099, Jilin, China.
Wanyan LiuDepartment of Critical Care Medicine, Jilin Hospital of Integrative Chinese and Western Medicine, Jilin, 132012, Jilin, China.
Changgang LiuDepartment of Critical Care Medicine, Tonghua Central Hospital, Tonghua, 134099, Jilin, China.
Qingsong CuiDepartment of Critical Care Medicine, Yanbian University Affiliated Hospital, Yanji, 133099, Jilin, China.
Shunzi WuDepartment of Critical Care Medicine, People's Hospital of Hunchun City, Hunchun, 133399, Jilin, China.
Hongmei JiangDepartment of Critical Care Medicine, Baicheng City Hospital, Baicheng, 137099, Jilin, China.
Wenge LiuDepartment of Critical Care Medicine, Jilin City Central Hospital, Jilin, 132011, Jilin, China.
Weiheng LiuDepartment of Critical Care Medicine, Jilin City Central Hospital, Jilin, 132011, Jilin, China.
Hongguang XuDepartment of Critical Care Medicine, Jilin City Central Hospital, Jilin, 132011, Jilin, China.
Gang LiDepartment of Critical Care Medicine, Changchun Central Hospital, Changchun, 130041, Jilin, China.
Yuyan CaiDepartment of Critical Care Medicine, Jilin City People's Hospital, Jilin, 132001, Jilin, China.
Liting ChenRespiratory Intensive Care Unit, Jilin City People's Hospital, Jilin, 132001, Jilin, China.
Bingwei ChenDepartment of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China.
Dong ZhangDepartment of Critical Care Medicine, The First Hospital of Jilin University, Changchun, 130021, Jilin, China. zhangdong@jlu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent studies suggest that neutrophil elastase inhibitor (Sivelestat) may improve pulmonary function and reduce mortality in patients with acute respiratory distress syndrome. We examined the association between receipt of sivelestat and improvement in oxygenation among patients with acute respiratory distress syndrome (ARDS) induced by COVID-19.

methodsA large multicentre cohort study of patients with ARDS induced by COVID-19 who had been admitted to intensive care units (ICUs). We used propensity score matching to compare the outcomes of patients treated with sivelestat to those who were not. The differences in continuous outcomes were assessed with the Wilcoxon signed-rank test. Kaplan-Meier method was used to show the 28-day survival curves in the matched cohorts. A log-rank P-test stratified on the matched pairs was used to test the equality of the estimated survival curves. A Cox proportional hazards model that incorporated a robust sandwich-type variance estimator to account for the matched nature of the data was used to estimate hazard ratios (HR). All statistical analyses were performed with SPSS 26.0 and R 4.2.3. A two-sided p-value of < 0.05 was considered statistically significant.

resultsA total of 387 patients met inclusion criteria, including 259 patients (66.9%) who were treated with sivelestat. In 158 patients matched on the propensity for treatment, receipt of sivelestat was associated with improved oxygenation, decreased Murray lung injury score, increased non-mechanical ventilation time within 28 days, increased alive and ICU-free days within 28 days (HR, 1.85; 95% CI 1.29 to 2.64; log-rank p < 0.001), shortened ICU stay and ultimately improved survival (HR, 2.78; 95% CI 1.32 to 5.88; log-rank p = 0.0074).

conclusionsAmong patients with ARDS induce by COVID-19, sivelestat administration is associated with improved clinical outcomes.

Indexed as

COVID-19COVID-19 Drug TreatmentGlycineLeukocyte ElastaseProteinase Inhibitory Proteins, SecretoryRespiratory Distress SyndromeSerine Proteinase InhibitorsSulfonamidesAgedCohort StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeGlycineLeukocyte ElastaseProteinase Inhibitory Proteins, SecretorySerine Proteinase InhibitorssivelestatSulfonamidesAcute respiratory distress syndromeCOVID-19Neutrophil elastaseSivelestatSurvival

Identifiers

PMID39827089
PMCPMC11743030

What OpenQuestion holds

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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.