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Intravenous High-dose Anakinra Drops Venous Thrombosis and Myocardial Infarction in Severe and Critical COVID-19 Patients: A Propensity Score Matched Study
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  • Murat Bektas,
  • Ramazan Çakmak,
  • Servet Yüce,
  • Muhammed Hamdi Uyar,
  • Mustafa Ay,
  • Muhammed İkbal Kılıç
Murat Bektas
Aksaray Universitesi Tip Fakultesi

Corresponding Author:murat.b88@hotmail.com

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Ramazan Çakmak
Istinye Universitesi
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Servet Yüce
Istanbul Universitesi Istanbul Tip Fakultesi
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Muhammed Hamdi Uyar
Aksaray Universitesi Tip Fakultesi
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Mustafa Ay
Aksaray Universitesi Tip Fakultesi
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Muhammed İkbal Kılıç
Aksaray Universitesi Tip Fakultesi
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Abstract

Introduction: In our study, we aimed to evaluate the effect of high dose intravenous anakinra treatment on development of thrombotic events in severe and critical COVID-19 patients. Material and methods: This retrospective observational study was conducted at a tertiary referral center in Aksaray, Turkey. The study population consisted of two groups as follows; the patients receiving high dose intravenous anakinra (anakinra group) added to background therapy and the patients treated with standard of care (SoC) as historical control group. Age, gender, mcHIS scores, and comorbidities such as DM, HT, and CHD of the patients were determined as the variables to be matched. Results: We included 114 patients in SoC and 139 patients in Anakinra group into the study. Development of any thromboembolic event (5% vs 12.3%, p=0.038; OR:4.3) and PTE (2.9% vs 9.6%, p=0.023; OR:5.1) were lower in Anakinra group than SoC. No patient experienced CVA and/or clinically evident DVT both in two arms. After 1:1 PS matching, 88 patients in SoC and 88 patients in Anakinra group were matched and included into the analysis. In survival analysis, development of any thromboembolic event, PTE, and MI were higher in SoC compared to Anakinra. Survival rate was also lower in patients with SoC arm than Anakinra in patients who had any thromboembolic event as well as MI. Conclusion: In our study, development of thrombosis were associated with hyperinflammation in patients with severe and critical COVID-19. Intravenous high-dose anakinra treatment decreases both venous and arterial events in patients with COVID-19.
18 Oct 2023Submitted to Journal of Medical Virology
18 Oct 2023Submission Checks Completed
18 Oct 2023Assigned to Editor
18 Oct 2023Review(s) Completed, Editorial Evaluation Pending
30 Oct 2023Reviewer(s) Assigned