Intravenous High-dose Anakinra Drops Venous Thrombosis and Myocardial
Infarction in Severe and Critical COVID-19 Patients: A Propensity Score
Matched Study
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.