{"id":440,"date":"2020-08-19T09:02:57","date_gmt":"2020-08-19T09:02:57","guid":{"rendered":"https:\/\/nclinnovations.org\/covid19monitor\/?p=440"},"modified":"2020-08-19T09:02:57","modified_gmt":"2020-08-19T09:02:57","slug":"10-aug-2020-tocilizumab-anakinra-prompt-identification-and-treatment-of-covid19-cs-prior-to-intubation-important","status":"publish","type":"post","link":"https:\/\/nclinnovations.org\/covid19monitor\/10-aug-2020-tocilizumab-anakinra-prompt-identification-and-treatment-of-covid19-cs-prior-to-intubation-important\/","title":{"rendered":"(10 Aug 2020) Tocilizumab, Anakinra- Prompt identification and treatment of COVID19-CS prior to intubation important"},"content":{"rendered":"<div class=\"boldgrid-section\">\n<div class=\"container\">\n<div class=\"row\">\n<div class=\"col-md-12 col-xs-12 col-sm-12\">\n<p class=\"\">Early Identification of COVID-19 Cytokine Storm and Treatment with Anakinra or Tocilizumab<\/p>\n<p class=\"\"><a href=\"https:\/\/www.ijidonline.com\/article\/S1201-9712(20)30609-3\/fulltext\">https:\/\/www.ijidonline.com\/article\/S1201-9712(20)30609-3\/fulltext<\/a><\/p>\n<p class=\"\">In a retrospective cohort study, at &nbsp;tocilizumab initiation (n = 52), 50 (96.2%) were intubated, and only 7 (13.5%) received concomitant corticosteroids. At anakinra initiation (n = 41), 23 (56.1%) were intubated, and all received concomitant corticosteroids. Fewer anakinra-treated patients died (n = 9, 22%) and more were extubated\/never intubated (n = 26, 63.4%) compared to tocilizumab-treated patients (n = 24, 46.2% dead, n = 22, 42.3% extubated\/never intubated). Patients who died had more severe sepsis and respiratory failure and met COVID-CS laboratory criteria longer (median = 3 days) compared to those extubated\/never intubated (median = 1 day). After accounting for differences in disease severity at treatment initiation, this apparent superiority of anakinra over tocilizumab was no longer statistically significant (propensity score-adjusted hazards ratio 0.46, 95% confidence interval 0.18-1.20). Prompt identification and treatment of COVID19-CS prior to intubation may be more important than the specific type of anti-inflammatory treatment. Randomized controlled trials of targeted anti-cytokine treatments and corticosteroids should report duration of cytokine storm in addition to clinical severity at randomization.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Early Identification of COVID-19 Cytokine Storm and Treatment with Anakinra or Tocilizumab https:\/\/www.ijidonline.com\/article\/S1201-9712(20)30609-3\/fulltext In a retrospective cohort study, at &nbsp;tocilizumab initiation (n = 52), 50 (96.2%) were intubated, and only 7 (13.5%) received concomitant corticosteroids. At anakinra initiation (n =&hellip; <span class=\"read-more-span\"><a href=\"https:\/\/nclinnovations.org\/covid19monitor\/10-aug-2020-tocilizumab-anakinra-prompt-identification-and-treatment-of-covid19-cs-prior-to-intubation-important\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;(10 Aug 2020) Tocilizumab, Anakinra- Prompt identification and treatment of COVID19-CS prior to intubation important&#8221;<\/span> <span class=\"genericon genericon-next\"><\/span><\/a><\/span><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"bgseo_title":"","bgseo_description":"","bgseo_robots_index":"index","bgseo_robots_follow":"follow"},"categories":[56,4,18],"tags":[57,27],"_links":{"self":[{"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/posts\/440"}],"collection":[{"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/comments?post=440"}],"version-history":[{"count":1,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/posts\/440\/revisions"}],"predecessor-version":[{"id":441,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/posts\/440\/revisions\/441"}],"wp:attachment":[{"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/media?parent=440"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/categories?post=440"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/tags?post=440"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}