Delayed Use of the Recombinant Human IL-1 Receptor Antagonist Anakinra in Five COVID-19 Patients with Pulmonary Fibrosis and Persistent Hypoxaemia: A Preliminary Report
  • Daniel Nan
    Internal Medicine Department, University Hospital Marqués de Valdecilla, Santander, Spain; University of Cantabria, Santander, Spain
  • Cristina Abraira-Meriel
    Dermatology Department, University Hospital Marqués de Valdecilla, Santander, Spain
  • Sandra de la Roz-Fernandez
    Internal Medicine Department, University Hospital Marqués de Valdecilla, Santander, Spain
  • Tamara Maestre-Orozco
    Internal Medicine Department, University Hospital Marqués de Valdecilla, Santander, Spain
  • Jose Luis Hernandez
    Internal Medicine Department, University Hospital Marqués de Valdecilla, Santander, Spain; University of Cantabria, Santander, Spain
  • Marta Fernandez-Ayala
    Internal Medicine Department, University Hospital Marqués de Valdecilla, Santander, Spain

Keywords

Pulmonary fibrosis, COVID-19, anakinra

Abstract

Coronavirus disease 2019 (COVID-19) is currently a major public health problem. The development of pulmonary fibrosis secondary to acute respiratory distress syndrome (ARDS) is one of the expected sequelae. In this case series, we describe five instances of the use of anakinra in late-phase COVID-19 pneumonia in hospitalized patients with pulmonary fibrosis and refractory respiratory failure fulfilling ARDS criteria. The study demonstrates that anakinra has promising efficacy and safety in late-phase COVID-19 infection in patients with ARDS and refractory hypoxaemia, and suggests its potential application as antifibrotic therapy in these patients.

VIEW THE ENTIRE ARTICLE

References

  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054–1062.
  • George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respir Med 2020;8(8):807–815.
  • Borthwick LA. The IL-1 cytokine family and its role in inflammation and fibrosis in the lung. Semin Immunopathol 2016;38(4):517–534.
  • Khan FA, Stewart I, Fabbri L, Moss S, Robinson K, Smyth AR, et al. Systematic review and meta-analysis of anakinra, sarilumab, siltuximab and tocilizumab for COVID-19. Thorax 2021;76(9):907–919.
  • Spagnolo P, Balestro E, Aliberti S, Cocconcelli E, Biondini D, Della Casa G, et al. Pulmonary fibrosis secondary to COVID-19: a call to arms? Lancet Respir Med 2020;8(8):750–752.
  • RECOVERY Collaborative Group, Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, et al. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med 2021;384(8):693–704.
  • Aouba A, Baldolli A, Geffray L, Verdon R, Bergot E, Martin-Silva N, Justet A. Targeting the inflammatory cascade with anakinra in moderate to severe COVID-19 pneumonia: case series. Ann Rheum Dis 2020;79(10):1381–1382.
  • Cavalli G, De Luca G, Campochiaro C, Della-Torre E, Ripa M, Canetti D, et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol 2020;2(6):e325–e331.
  • CORIMUNO-19 Collaborative Group. Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial. Lancet Respir Med 2021;9(3):295–304.
  • Jia X, Liu B, Bao L, Lv Q, Li F, Li H, et al. Delayed oseltamivir plus sirolimus treatment attenuates H1N1 virus-induced severe lung injury correlated with repressed NLRP3 inflammasome activation and inflammatory cell infiltration. PLoS Pathog 2018;14(11):e1007428.
  • Zhang C, Wu Z, Li J-W, Tan K, Yang W, Zhao H, et al. Discharge may not be the end of treatment: pay attention to pulmonary fibrosis caused by severe COVID-19. J Med Virol 2020;93(3):1378–1386.
  • Lechowicz K, Drozdzal S, Machaj F, Rosik J, Szostak B, Zegan-Baranska M, et al. COVID-19: the potential treatment of pulmonary fibrosis associated with SARS-CoV-2 infection. J Clin Med 2020;9(6):1917.
  • Views: 842
    HTML downloads: 70
    PDF downloads: 267


    Published: 2021-10-08
    Issue: 2021: Vol 8 No 10 (view)


    How to cite:
    1.
    Nan D, Abraira-Meriel C, de la Roz-Fernandez S, Maestre-Orozco T, Hernandez JL, Fernandez-Ayala M. Delayed Use of the Recombinant Human IL-1 Receptor Antagonist Anakinra in Five COVID-19 Patients with Pulmonary Fibrosis and Persistent Hypoxaemia: A Preliminary Report. EJCRIM 2021;8 doi:10.12890/2021_002821.