Efficacy of Thymosin Alpha 1 in the Treatment of COVID-19: A Multicenter Cohort Study

BackgroundThymosin alpha 1 (Tα1) is widely used to treat patients with COVID-19 in China; however, its efficacy remains unclear. This study aimed to explore the efficacy of Tα1 as a COVID-19 therapy.MethodsWe performed a multicenter cohort study in five tertiary hospitals in the Hubei province of China between December 2019 and March 2020. The patient non-recovery rate was used as the primary outcome.ResultsAll crude outcomes, including non-recovery rate (65/306 vs. 290/1,976, p = 0.003), in-hospital mortality rate (62/306 vs. 271/1,976, p = 0.003), intubation rate (31/306 vs. 106/1,976, p = 0.001), acute respiratory distress syndrome (ARDS) incidence (104/306 vs. 499/1,976, p = 0.001), acute kidney injury (AKI) incidence (26/306 vs. 66/1,976, p < 0.001), and length of intensive care unit (ICU) stay (14.9 ± 12.7 vs. 8.7 ± 8.2 days, p < 0.001), were significantly higher in the Tα1 treatment group. After adjusting for confounding factors, Tα1 use was found to be significantly associated with a higher non-recovery rate than non-Tα1 use (OR 1.5, 95% CI 1.1–2.1, p = 0.028). An increased risk of non-recovery rate associated with Tα1 use was observed in the patient subgroups with maximum sequential organ failure assessment (SOFA) scores ≥2 (OR 2.0, 95%CI 1.4–2.9, p = 0.024), a record of ICU admission (OR 5.4, 95%CI 2.1–14.0, p < 0.001), and lower PaO2/FiO2 values (OR 1.9, 95%CI 1.1–3.4, p = 0.046). Furthermore, later initiation of Tα1 use was associated with a higher non-recovery rate.ConclusionTα1 use in COVID-19 patients was associated with an increased non-recovery rate, especially in those with greater disease severity.

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The Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2020.12.007 ◽

2021 ◽

Author(s):

Dennis G. Moledina ◽

Michael Simonov ◽

Yu Yamamoto ◽

Jameel Alausa ◽

Tanima Arora ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cohort Study ◽

Kidney Injury ◽

Severity Of Illness ◽

Multicenter Cohort Study ◽

Multicenter Cohort

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Increased risk of death and readmission after hospital discharge of critically ill patients in a developing country: a retrospective multicenter cohort study

Intensive Care Medicine ◽

10.1007/s00134-018-5252-3 ◽

2018 ◽

Vol 44 (7) ◽

pp. 1090-1096 ◽

Cited By ~ 3

Author(s):

Vanessa Chaves Barreto Ferreira de Lima ◽

Ana Luiza Bierrenbach ◽

Gizelton Pereira Alencar ◽

Ana Lucia Andrade ◽

Luciano Cesar Pontes Azevedo

Keyword(s):

Cohort Study ◽

Developing Country ◽

Hospital Discharge ◽

Critically Ill ◽

Critically Ill Patients ◽

Multicenter Cohort Study ◽

Risk Of Death ◽

Multicenter Cohort ◽

Increased Risk

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Increased risk for postoperative periprosthetic fracture in hip fracture patients with the Exeter stem than the anatomic SP2 Lubinus stem

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-019-01263-6 ◽

2019 ◽

Cited By ~ 1

Author(s):

Carl Mellner ◽

Jabbar Mohammed ◽

Magnus Larsson ◽

Sandra Esberg ◽

Maciej Szymanski ◽

...

Keyword(s):

Cohort Study ◽

Cumulative Incidence ◽

Periprosthetic Fracture ◽

Consecutive Series ◽

Multicenter Cohort Study ◽

Multicenter Cohort ◽

Increased Risk ◽

Neck Fracture ◽

C 32

Abstract Background The purpose of this study was to compare the cumulative incidence of postoperative periprosthetic fracture (PPF) in a cohort of femoral neck fracture (FNF) patients treated with two commonly used cemented stems: either a collarless, polished, tapered Exeter stem or the anatomic Lubinus SP2 stem. Methods In this retrospective multicenter cohort study of a consecutive series of patients, we included 2528 patients of age 60 years and above with an FNF who were treated with either hemiarthroplasty or total hip arthroplasty using either a polished tapered Exeter stem or an anatomic Lubinus SP2 stem. The incidence of PPF was assessed at a minimum of 2 years postoperatively. Results The incidence of PPF was assessed at a median follow-up of 47 months postoperatively. Thirty nine patients (1.5%) sustained a PPF at a median of 27 months (range 0–96 months) postoperatively. Two of the operatively treated fractures were Vancouver A (5%), 7 were Vancouver B1 (18%), 10 were Vancouver B2 (26%), 7 were Vancouver B3 (18%), and 13 were Vancouver C (32%). The cumulative incidence of PPF was 2.3% in the Exeter group compared with 0.7% in the SP2 group (p < 0.001). The HR was 5.4 (95% CI 2.4–12.5, p < 0.001), using the SP2 group as the denominator. Conclusions The Exeter stem was associated with a higher risk for PPF than the Lubinus SP2 stem. We suggest that the tapered Exeter stem should be used with caution in the treatment of FNF. Trial registration The study was registered at clinicaltrials.gov (identifier: NCT03326271).

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Impact of acute kidney injury in expanded criteria deceased donors on post-transplant clinical outcomes: multicenter cohort study

BMC Nephrology ◽

10.1186/s12882-019-1225-1 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 4

Author(s):

Woo Yeong Park ◽

Min-Seok Choi ◽

Young Soo Kim ◽

Bum Soon Choi ◽

Cheol Whee Park ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cohort Study ◽

Clinical Outcomes ◽

Kidney Injury ◽

Multicenter Cohort Study ◽

Post Transplant ◽

Multicenter Cohort ◽

Expanded Criteria ◽

Deceased Donors

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Development of biomarker combinations for postoperative acute kidney injury via Bayesian model selection in a multicenter cohort study

Biomarker Research ◽

10.1186/s40364-018-0117-z ◽

2018 ◽

Vol 6 (1) ◽

Cited By ~ 3

Author(s):

Allison Meisner ◽

Kathleen F. Kerr ◽

Heather Thiessen-Philbrook ◽

Francis Perry Wilson ◽

Amit X. Garg ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cohort Study ◽

Model Selection ◽

Bayesian Model ◽

Kidney Injury ◽

Bayesian Model Selection ◽

Multicenter Cohort Study ◽

Multicenter Cohort

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Higher Survival Rate Associated with Thymosin Alpha 1 use in Critical COVID-19: A Retrospective Multicenter Cohort Study

10.21203/rs.3.rs-123265/v1 ◽

2020 ◽

Author(s):

Yichen Li ◽

Jie Li ◽

Jia Ke ◽

Sijing Cheng ◽

Lixin Zhu ◽

...

Keyword(s):

Logistic Regression ◽

Cohort Study ◽

Retrospective Study ◽

Protective Factor ◽

Confounding Factors ◽

Multivariate Logistic Regression ◽

Multicenter Cohort Study ◽

Multicenter Cohort ◽

Thymosin Alpha 1 ◽

Critical Patients

Abstract BackgroundCurrently no satisfactory pharmaceutical intervention is available for COVID-19. This retrospective study aimed to determine the therapeutic effect of thymosin alpha1 in critical COVID-19. ResultsWe enrolled 109 critically ill severe acute respiratory syndrome-related coronavirus-2 RNA positive patients from 15 hospitals. The mortality rate in critical patients treated with thymosin alpha1 was 11%, compared to 56% in critical patients not treated with thymosin alpha1. With confounding factors adjusted in multivariate logistic regression, thymosin alpha1 treatment was identified as a protective factor for critical COVID-19. ConclusionOur observation advocates the treatment of critical COVID-19 with thymosin alpha1.

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COMBINATION OF TOCILIZUMAB AND STEROIDS TO IMPROVE MORTALITY IN PATIENTS WITH SEVERE COVID-19 INFECTION: A SPANISH, MULTICENTER, COHORT STUDY

10.1101/2020.09.07.20189357 ◽

2020 ◽

Cited By ~ 1

Author(s):

Belen Ruiz-Antoran ◽

Aranzazu Sancho-Lopez ◽

Ferran Torres ◽

Victor Moreno-Torres ◽

Itziar de Pablo Lopez de Abechuco ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort ◽

Oxygen Therapy ◽

Inclusion Criteria ◽

Multicenter Cohort Study ◽

Inverse Probability ◽

Multicenter Cohort ◽

Tertiary Hospitals ◽

Randomised Controlled ◽

The Impact

Background: We aimed to determine the impact of tocilizumab use in severe COVID-19 pneumonia mortality. Methods: We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain, from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocilizumab were compared to patients not treated with tocilizumab, adjusting by Inverse Probability of the Treatment Weights (IPTW). Tocilizumab effect in patients receiving steroids during the 48h following inclusion was analyzed. Results: During the study period, 506 patients with severe COVID-19 fulfilled inclusion criteria. Among them, 268 were treated with tocilizumab and 238 patients were not. Median time to tocilizumab treatment from onset of symptoms was 11 days (IQR 8-14). Global mortality was 23.7%. Mortality was lower in patients treated with tocilizumab than in controls (16.8% versus 31.5%, HR 0.514 [95CI 0.355-0.744], p<0.001; weighted HR 0.741 [95CI 0.619-0.887], p=0.001). Tocilizumab treatment reduced mortality by 14.7% relative to no tocilizumab treatment (RRR 46.7%). We calculated a number necessary to treat of 7. Among patients treated with steroids, mortality was lower in patients treated with tocilizumab than in those treated with steroids alone (10.9% versus 40.2%, HR 0.511 [95CI 0.352-0.741], p=0.036; weighted HR 0.6 [95CI 0.449-0.804], p<0.001) (Interaction p=0.094). Conclusions: These results show that survival of patients with severe COVID-19 is higher in patients treated with tocilizumab than in those not treated, and that tocilizumab effect adds to that of steroids administered to non-intubated cases with COVID-19 during the first 48 hours of presenting with respiratory failure despite of oxygen therapy. Randomised controlled studies are needed to confirm these results.

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