RESUMEN
OBJECTIVE: The aim of this study was to evaluate the efficacy of anakinra in patients who were admitted to hospital for severe COVID-19 pneumonia requiring oxygen therapy. METHODS: A prospective, open-label, interventional study in adults hospitalized with severe COVID-19 pneumonia was conducted. Patients in the interventional arm received subcutaneous anakinra (100 mg twice daily for 3 days, followed by 100 mg daily for 7 days) in addition to standard treatment. Main outcomes were the need for mechanical ventilation and in-hospital death. Secondary outcomes included successful weaning from supplemental oxygen and change in inflammatory biomarkers. Outcomes were compared with those of historical controls who had received standard treatment and supportive care. RESULTS: A total of 69 patients were included: 45 treated with anakinra and 24 historical controls. A need for mechanical ventilation occurred in 14 (31%) of the anakinra-treated group and 18 (75%) of the historical cohort (p < 0.001). In-hospital death occurred in 13 (29%) of the anakinra-treated group and 11 (46%) of the historical cohort (p = 0.082). Successful weaning from supplemental oxygen to ambient air was attained in 25 (63%) of the anakinra-treated group compared with 6 (27%) of the historical cohort (p = 0.008). Patients who received anakinra showed a significant reduction in inflammatory biomarkers. CONCLUSION: In patients with severe COVID-19 pneumonia and high oxygen requirement, anakinra could represent an effective treatment option and may confer clinical benefit. TRIAL REGISTRATION NUMBER: ISRCTN74727214.
Asunto(s)
COVID-19/terapia , Proteína Antagonista del Receptor de Interleucina 1/uso terapéutico , Oxígeno/uso terapéutico , SARS-CoV-2 , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Respiración ArtificialRESUMEN
Commercially important fresh (581) and frozen (292) marine fish samples of 10 species were collected from seafood factories and evaluated using AAS and ICP-OES. Metal levels significantly (p<0.05) varied within and between species. However, there were no significant correlations among metals. There were significant interspecific differences for all metals, and yellowfin tuna had the highest level of cadmium and mercury however, red seabream had maximum numbers above the standards. The metal accumulation significantly varied between bottom feeders of intermediately size locally caught fish. The mean cadmium level ranged from 0.0049 to 0.036 mg kg(-1) and 1.37% of the total samples exceeded the EU and FAO standards. Mean lead content varied between 0.029 and 0.196 mg kg(-1), few samples crossed the EU (2.63%) and FAO (1.6%) limits. Mean mercury level ranged from 0.015 to 0.101 mg kg(-1) and none of the samples exceeded the EU limit. Of the total samples analyzed red seabream (2.06%), yellowfin tuna (1.14%), emperor (0.34%), santer bream (0.22%), king fish (0.11%) and skipjack tuna (0.11%) samples crossed the EU limits. In general, fish from these regions are within the safety levels recommended by various organizations and do not pose a health risk in terms of human diet.