Background: Hyperinflammation-induced respiratory failure is a leading cause of mortality in COVID-19 infection. Immunosuppressants such as, Baricitinib and interleukin inhibitors are the drug-of-choice to suppress cytokine storm in COVID-19. Here, we compared the therapeutic safety and efficacy of triple-immunosuppressants with dual-immunosuppressants in patients with severe-to-critical COVID-19.
Methods: This study was conducted on 103 confirmed COVID-19 patients. Of 103 patients, 49 (N) and 54 (N) patients received dual-immunosuppressants (baricitinib plus two doses of secukinumab) and triple immunosuppressants (baricitinib plus single dose of tocilizumab and secukinumab) in group A and group B, respectively. Groups were compared in terms of clinical outcome, critical support-requirement, survival, re-hospitalisation, and adverse events (AEs).
Results: Patients in group B achieved normal blood oxygen saturation level (SpO) earlier than the patients of group A [4 day (IQR: 3-12) vs 5 day (IQR: 5-14), < .05]. The requirement of intensive care unit (ICU) and mechanical ventilation (MV) support was less in group B than group A [16.7%/28.6%, 11.1%/18.4%, respectively < .05]]. The incidence of COVID-19 acute respiratory distress syndrome and 60-day all cause mortality was reduced in group B compared to group A [0.43 (0.19-0.98), < .05; 0.35 (0.08-1.44), > .05]. The 60-day re-hospitalisation rate was two-fold high in group A than group B ( = .024). Immunosuppressant-associated adverse events and secondary bacterial/fungal infections were relative high in patients of group B.
Conclusions: Triple-immunosuppressants in severe-to-critical COVID-19 infection exhibited better clinical outcome; reduced ICU and MV requirement; shorter hospital stay with deceased 60-day all cause mortality and re-hospitalisation compared to dual-immunosuppressants.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903771 | PMC |
http://dx.doi.org/10.1080/07853890.2022.2039958 | DOI Listing |
Mol Biotechnol
December 2024
Unit of Scientific Research, Applied College, Qassim University, Buraydah, 52571, Saudi Arabia.
The Zika virus (ZIKV), an arbovirus within the Flavivirus genus, is associated with severe neurological complications, including Guillain-Barré syndrome in affected individuals and microcephaly in infants born to infected mothers. With no approved vaccines or antiviral treatments available, there is an urgent need for effective therapeutic options. This study aimed to identify new natural compounds with inhibitory potential against the NS2B-NS3 protease (PDB ID: 5LC0), an essential enzyme in viral replication.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Children's Regional Medical Center, National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, 310052, Zhejiang Province, China.
Williams Syndrome (WS) is a rare neurodevelopmental disorder with a prevalence of 1 in 7500 to 1 in 20,000 individuals, caused by a microdeletion in chromosome 7q11.23. Despite its distinctive clinical features, the underlying metabolic alterations remain largely unexplored.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Cardiology, West China Hospital of Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan, China.
Intracardiac echocardiography (ICE) has been used to guide radio-frequency catheter ablation (RFCA) for better catheter navigation and less radiation exposure in treating atrial fibrillation (AF). This retrospective cohort study enrolled 227 AF patients undergoing ICE- or traditional fluoroscopy (TF)-guided RFCA for AF in a tertiary hospital. ICE was used more often in patients with atrial tachycardia [odds ratio (OR) 3.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
This study aimed to evaluate the histological success of pulpotomy in primary molars using white mineral trioxide aggregate (WMTA) mixed with 2.25% sodium hypochlorite (NaOCl) gel and to evaluate in vitro its physical and chemical properties. The study had a clinical stage and an in-vitro stage.
View Article and Find Full Text PDFSci Rep
December 2024
Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Very high heat is generated during the polymerization of poly (methyl methacrylate) (PMMA) bone cement, which is used for implant fixation in orthopedic surgery. As such, it has been suggested that irrigating the bone cement layer in the surgical site with a saline solution is a way of cooling the layer. In this study, we aimed to determine the influence of irrigation with a saline solution on the flexural strength and the microstructure of the test specimens of two PMMA bone cement brands: Simplex P and FIX 1.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!