6 research outputs found
Development and validation of SCOPE score: a clinical score to predict progression of COVID-19 pneumonia to severe respiratory failure
Most patients infected with SARS-CoV-2 (COVID-19) experience mild, non-specific symptoms, but many develop severe symptoms associated with an excessive inflammatory response. Elevated plasma concentrations of soluble urokinase plasminogen activator receptor (suPAR) provide early warning of progression to severe respiratory failure (SRF) or death, but access to suPAR testing may be limited. The Severe COvid Prediction Estimate (SCOPE) score, derived from circulating concentrations of C-reactive protein, D- dimers, interleukin-6, and ferritin among patients not receiving non-invasive or invasive mechanical ventilation during the SAVE-MORE study, offers predictive accuracy for progression to SRF or death within 14 days comparable to that of a suPAR concentration of ≥6 ng/mL (area under receiver operator characteristic curve 0.81 for both). The SCOPE score is validated in two similar independent cohorts. A SCOPE score of 6 or more is an alternative to suPAR for predicting progression to SRF or death within 14 days of hospital admission for pneumonia, and it can be used to guide treatment decisions
Early treatment of COVID-19 with anakinra guided by soluble urokinase plasminogen receptor plasma levels: a double-blind, randomized controlled phase 3 trial
Early increase of soluble urokinase plasminogen activator receptor (suPAR) serum levels is indicative of increased risk of progression of coronavirus disease 2019 (COVID-19) to respiratory failure. The SAVE-MORE double-blind, randomized controlled trial evaluated the efficacy and safety of anakinra, an IL-1 alpha/beta inhibitor, in 594 patients with COVID-19 at risk of progressing to respiratory failure as identified by plasma suPAR >= 6 ng ml(-1), 85.9% (n = 510) of whom were receiving dexamethasone. At day 28, the adjusted proportional odds of having a worse clinical status (assessed by the 11-point World Health Organization Clinical Progression Scale (WHO-CPS)) with anakinra, as compared to placebo, was 0.36 (95% confidence interval 0.26-0.50). The median WHO-CPS decrease on day 28 from baseline in the placebo and anakinra groups was 3 and 4 points, respectively (odds ratio (OR) = 0.40, P < 0.0001); the respective median decrease of Sequential Organ Failure Assessment (SOFA) score on day 7 from baseline was 0 and 1 points (OR = 0.63, P = 0.004). Twenty-eight-day mortality decreased (hazard ratio = 0.45, P = 0.045), and hospital stay was shorter.The SAVE-MORE phase 3 study demonstrates the efficacy of anakinra, an IL-1 alpha/beta inhibitor, in patients with COVID-19 and high serum levels of soluble plasminogen activator receptor
Early treatment of COVID-19 with anakinra guided by soluble urokinase plasminogen receptor plasma levels: a double-blind, randomized controlled phase 3 trial
Early increase of soluble urokinase plasminogen activator receptor
(suPAR) serum levels is indicative of increased risk of progression of
coronavirus disease 2019 (COVID-19) to respiratory failure. The
SAVE-MORE double-blind, randomized controlled trial evaluated the
efficacy and safety of anakinra, an IL-1 alpha/beta inhibitor, in 594
patients with COVID-19 at risk of progressing to respiratory failure as
identified by plasma suPAR >= 6 ng ml(-1), 85.9% (n = 510) of whom were
receiving dexamethasone. At day 28, the adjusted proportional odds of
having a worse clinical status (assessed by the 11-point World Health
Organization Clinical Progression Scale (WHO-CPS)) with anakinra, as
compared to placebo, was 0.36 (95% confidence interval 0.26-0.50). The
median WHO-CPS decrease on day 28 from baseline in the placebo and
anakinra groups was 3 and 4 points, respectively (odds ratio (OR) =
0.40, P < 0.0001); the respective median decrease of Sequential Organ
Failure Assessment (SOFA) score on day 7 from baseline was 0 and 1
points (OR = 0.63, P = 0.004). Twenty-eight-day mortality decreased
(hazard ratio = 0.45, P = 0.045), and hospital stay was shorter.
The SAVE-MORE phase 3 study demonstrates the efficacy of anakinra, an
IL-1 alpha/beta inhibitor, in patients with COVID-19 and high serum
levels of soluble plasminogen activator receptor