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10.1016/j.ijid.2020.07.081 http://scihub22266oqcxt.onion/10.1016/j.ijid.2020.07.081 32768693!7406519!32768693     free     free     free Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Int+J+Infect+Dis 2020 ; 99 (ä): 291-297 Nephropedia Template TP {{tp|p=32768693|t=2020. Early identification of COVID-19 cytokine storm and treatment with anakinra or tocilizumab |pdf=|usr=}}{{32768693}} gab.com Text Early identification of COVID-19 cytokine storm and treatment with anakinra or tocilizumab JO: Int J Infect Dis http://www.kidney.de/pget.php?&tw=1&pmid=32768693 #FOAvip OBJECTIVE: To examine outcomes among patients who were treated with the targeted anti-cytokine agents, anakinra or tocilizumab, for COVID-19 -related cytokine storm (COVID19-CS). METHODS: We conducted a retrospective cohort study of all SARS-coV2-RNA-positive patients treated with tocilizumab or anakinra in Kaiser Permanente Southern California. Local experts developed and implemented criteria to define COVID19-CS. All variables were extracted from electronic health records. RESULTS: At tocilizumab initiation (n = 52), 50 (96.2%) were intubated, and only seven (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). CONCLUSIONS: Prompt identification and treatment of COVID19-CS before 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 the duration of cytokine storm in addition to clinical severity at randomization. Twit Text FOAVip Early identification of COVID-19 cytokine storm and treatment with anakinra or tocilizumab ????Int J Infect Dis http://www.kidney.de/pget.php?&tw=1&pmid=32768693 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32768693 #FOAvip English Wikipedia <ref>{{Cite pmid|32768693}}</ref> Early identification of COVID-19 cytokine storm and treatment with anakinra or tocilizumab #MMPMID32768693 Langer-Gould A; Smith JB; Gonzales EG; Castillo RD; Figueroa JG; Ramanathan A; Li BH; Gould MK Int J Infect Dis 2020[Oct]; 99 (ä): 291-297 PMID32768693show ga OBJECTIVE: To examine outcomes among patients who were treated with the targeted anti-cytokine agents, anakinra or tocilizumab, for COVID-19 -related cytokine storm (COVID19-CS). METHODS: We conducted a retrospective cohort study of all SARS-coV2-RNA-positive patients treated with tocilizumab or anakinra in Kaiser Permanente Southern California. Local experts developed and implemented criteria to define COVID19-CS. All variables were extracted from electronic health records. RESULTS: At tocilizumab initiation (n = 52), 50 (96.2%) were intubated, and only seven (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). CONCLUSIONS: Prompt identification and treatment of COVID19-CS before 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 the duration of cytokine storm in addition to clinical severity at randomization. |Adrenal Cortex Hormones/*therapeutic use[MESH] |Aged[MESH] |Anti-Inflammatory Agents/*therapeutic use[MESH] |Antibodies, Monoclonal, Humanized/*therapeutic use[MESH] |Betacoronavirus/*immunology[MESH] |COVID-19[MESH] |Coronavirus Infections/*drug therapy/immunology/virology[MESH] |Cytokines/*immunology[MESH] |Early Medical Intervention[MESH] |Female[MESH] |Humans[MESH] |Interleukin 1 Receptor Antagonist Protein/*therapeutic use[MESH] |Male[MESH] |Middle Aged[MESH] |Pandemics[MESH] |Pneumonia, Viral/*drug therapy/immunology/virology[MESH] |Retrospective Studies[MESH] |SARS-CoV-2[MESH]Early identification of COVID-19 cytokine storm and treatment with ana(epmc).pdf DeepDyve Pubget Overpricing