{"title":"抗炎治疗COVID-19的有效性和反应预测因素","authors":"I. Sukhomlinova, I. Bakulin, M. Kabanov","doi":"10.17816/mechnikov96603","DOIUrl":null,"url":null,"abstract":"BACKGROUND: According to the international guidelines and expert opinions, medicines for the treatment of COVID-19 are prescribed off-label; however, the final decision is made by a physician based on an assessment of the risk/benefit ratio for each patient. Global studies of the efficacy and safety of the use of baricitinib, tocilizumab, olokizumab, dexamethasone in the treatment of COVID-19 are ongoing. There is no information about comparative efficacy of these drugs and on the prognosis of their use in COVID-19. \nAIM: To compare the effects of pre-emptive anti-inflammatory therapy (PAT) with tocilizumab, olokizumab, baricitinib, dexamethasone in patients with COVID-19 to identify response predictors and the choice of the most effective treatment. \nMATERIALS AND METHODS: A retrospective analysis of 229 cases of severe and moderate course of COVID-19 requiring various types of UPT at the Hospital for War Veterans has been carried out. \nRESULTS: In the study of 229 clinical cases of severe COVID-19, it was found that the most significant predictors of the effects of anticytokine therapy include C-reactive protein (CRP), body mass index (BMI), body temperature, saturation level and the need for a certain type of oxygen support at the start of a therapy, platelet count, hematocrit, neutrophil count, and duration of the disease from its onset to development of signs of a cytokine storm. The probability of recovery in the patients with early appointment of UPT increases by 13%; the need for additional oxygen support increases the risk of mortality by 5.3 times as it increases with the transition to each subsequent level; an increase in the level of CRP by 1% increases the unfavorable prognosis; an increase in D-dimer worsens the prognosis by 16%. \nCONCLUSION: Based on the statistical data obtained by the method of stepwise regression analysis, was proposed method for predicting the effectiveness of proactive anti-inflammatory therapy in novel coronavirus infections.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"207 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Anti-inflammatory therapy for COVID-19: effectiveness and predictors of response\",\"authors\":\"I. Sukhomlinova, I. Bakulin, M. Kabanov\",\"doi\":\"10.17816/mechnikov96603\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND: According to the international guidelines and expert opinions, medicines for the treatment of COVID-19 are prescribed off-label; however, the final decision is made by a physician based on an assessment of the risk/benefit ratio for each patient. Global studies of the efficacy and safety of the use of baricitinib, tocilizumab, olokizumab, dexamethasone in the treatment of COVID-19 are ongoing. There is no information about comparative efficacy of these drugs and on the prognosis of their use in COVID-19. \\nAIM: To compare the effects of pre-emptive anti-inflammatory therapy (PAT) with tocilizumab, olokizumab, baricitinib, dexamethasone in patients with COVID-19 to identify response predictors and the choice of the most effective treatment. \\nMATERIALS AND METHODS: A retrospective analysis of 229 cases of severe and moderate course of COVID-19 requiring various types of UPT at the Hospital for War Veterans has been carried out. \\nRESULTS: In the study of 229 clinical cases of severe COVID-19, it was found that the most significant predictors of the effects of anticytokine therapy include C-reactive protein (CRP), body mass index (BMI), body temperature, saturation level and the need for a certain type of oxygen support at the start of a therapy, platelet count, hematocrit, neutrophil count, and duration of the disease from its onset to development of signs of a cytokine storm. The probability of recovery in the patients with early appointment of UPT increases by 13%; the need for additional oxygen support increases the risk of mortality by 5.3 times as it increases with the transition to each subsequent level; an increase in the level of CRP by 1% increases the unfavorable prognosis; an increase in D-dimer worsens the prognosis by 16%. \\nCONCLUSION: Based on the statistical data obtained by the method of stepwise regression analysis, was proposed method for predicting the effectiveness of proactive anti-inflammatory therapy in novel coronavirus infections.\",\"PeriodicalId\":12949,\"journal\":{\"name\":\"HERALD of North-Western State Medical University named after I.I. Mechnikov\",\"volume\":\"207 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-06-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"HERALD of North-Western State Medical University named after I.I. Mechnikov\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.17816/mechnikov96603\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"HERALD of North-Western State Medical University named after I.I. Mechnikov","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17816/mechnikov96603","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Anti-inflammatory therapy for COVID-19: effectiveness and predictors of response
BACKGROUND: According to the international guidelines and expert opinions, medicines for the treatment of COVID-19 are prescribed off-label; however, the final decision is made by a physician based on an assessment of the risk/benefit ratio for each patient. Global studies of the efficacy and safety of the use of baricitinib, tocilizumab, olokizumab, dexamethasone in the treatment of COVID-19 are ongoing. There is no information about comparative efficacy of these drugs and on the prognosis of their use in COVID-19.
AIM: To compare the effects of pre-emptive anti-inflammatory therapy (PAT) with tocilizumab, olokizumab, baricitinib, dexamethasone in patients with COVID-19 to identify response predictors and the choice of the most effective treatment.
MATERIALS AND METHODS: A retrospective analysis of 229 cases of severe and moderate course of COVID-19 requiring various types of UPT at the Hospital for War Veterans has been carried out.
RESULTS: In the study of 229 clinical cases of severe COVID-19, it was found that the most significant predictors of the effects of anticytokine therapy include C-reactive protein (CRP), body mass index (BMI), body temperature, saturation level and the need for a certain type of oxygen support at the start of a therapy, platelet count, hematocrit, neutrophil count, and duration of the disease from its onset to development of signs of a cytokine storm. The probability of recovery in the patients with early appointment of UPT increases by 13%; the need for additional oxygen support increases the risk of mortality by 5.3 times as it increases with the transition to each subsequent level; an increase in the level of CRP by 1% increases the unfavorable prognosis; an increase in D-dimer worsens the prognosis by 16%.
CONCLUSION: Based on the statistical data obtained by the method of stepwise regression analysis, was proposed method for predicting the effectiveness of proactive anti-inflammatory therapy in novel coronavirus infections.
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