Evidence map›Paper›PMID 40936775›Full record

Observational studyPeerJ2025

Comparative effectiveness of anti-inflammatory and antiviral therapies on NLR and survival outcomes in severe COVID-19: multicenter retrospective study.

Abbas Al Mutair, Muhammad Daniyal, Sameer A Alkubati, Hamdan Albaqawi, Awatif M Alrasheeday, Bushra Alshammari, Kawthar Alsaleh, Richard Mottershead, Hanan Alyami, Hanan F Alharbi and 1 more

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

Observational study in PeerJ, 2025. 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
–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

1 citing paper in PubMed.

  1. Observational
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

11 authors.

Abbas Al MutairResearch Center, Almoosa Specialist Hospital, Al-ahsa, Saudi Arabia.
Muhammad DaniyalResearch Center, Almoosa Specialist Hospital, Al-ahsa, Saudi Arabia.
Sameer A AlkubatiMedical Surgical Nursing Department, University of Hail, Hail, Saudi Arabia.
Hamdan AlbaqawiMedical Surgical Nursing Department, University of Hail, Hail, Saudi Arabia.
Awatif M AlrasheedayNursing Administration Department, University of Hail, Hail, Saudi Arabia.
Bushra AlshammariMedical Surgical Nursing Department, University of Hail, Hail, Saudi Arabia.
Kawthar AlsalehResearch Center, Almoosa Specialist Hospital, Al-ahsa, Saudi Arabia.
Richard MottersheadDepartment of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
Hanan AlyamiCollege of Nursing, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia.
Hanan F AlharbiDepartment of Maternity and Pediatric Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Awad Al-OmariAlmana Health Group, Al-Khobar, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The COVID-19 pandemic has highlighted the critical role of immune dysregulation and systemic inflammation in disease severity, particularly in patients with severe respiratory illness. Elevated levels of pro-inflammatory cytokines, such as IL-6, and biomarkers like the neutrophil-to-lymphocyte ratio (NLR) have been associated with worse outcomes. This study enrolled laboratory-confirmed SARS-CoV-2 patients with acute respiratory illness requiring intestive care unit (ICU) admission, including mechanical ventilation, to evaluate the effect of different treatments on NLR, neutrophil count (NC), and lymphocyte count (LC). Methods: A retrospective, multicenter, observational cohort study was conducted across 15 tertiary hospitals in Saudi Arabia, involving 1,490 ICU-admitted COVID-19 patients between March 1, 2020, and October 30, 2020. Data on patient demographics, comorbidities, laboratory results, and treatment outcomes were collected using the Research Electronic Data Capture (REDCap) system. The study evaluated the effect of different treatments on NLR, neutrophil count (NC), and lymphocyte count (LC). Results: This study utilized 1,490 patients in the study of whom 73.6% were male and 26.1% were female. The average age of patients was 56.2 years, with a mean NLR of 8.77 ± 8.64, showing significant systemic inflammation. Tocilizumab ( Conclusion: Among the evaluated therapies, tocilizumab and oseltamivir showed a consistent trend of lower NLR values in both survivors and non-survivors, compared to those not receiving these treatments. These findings suggest that tocilizumab and oseltamivir may offer some efficacy in modulating immune response (as measured by NLR) and potentially improving outcomes. However, due to observed weak correlations no single therapy alone appears sufficient to predict or reduce mortality, emphasizing the need for multimodal treatment strategies and further investigation into combined biomarker models.

Indexed as

Anti-Inflammatory AgentsAntiviral AgentsCOVID-19COVID-19 Drug TreatmentLymphocytesNeutrophilsAdultAgedAntibodies, Monoclonal, HumanizedFemaleHumansLymphocyte CountMaleMiddle AgedRetrospective StudiesSARS-CoV-2Antibodies, Monoclonal, HumanizedAnti-Inflammatory AgentsAntiviral AgentstocilizumabAntiviral drugsCritical careIllnessImmune responseInflammation biomarkerNeutrophil-to-Lymphocyte ratioRespiratory illness

Identifiers

PMID40936775
PMCPMC12422261

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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.