Clinical and laboratory characteristics of patients with severe COVID-19 undergoing gene engineering therapy

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Abstract

Background: One of the primary factors contributing to an increased risk of fatal outcomes in severe COVID-19 cases is the development of a cytokine storm, a hyperimmune response characterized by excessive cytokine release. Despite using biologic therapies, mortality rates in severe COVID-19 cases remain significantly high.

Aim: To analyze and evaluate the clinical and laboratory parameters of patients with severe COVID-19 who received biologic therapy.

Materials and methods: A cluster sampling method was employed, with clusters selected based on the severity of the primary disease and biologic therapy. The study included 65 patients, divided into two groups based on disease outcomes: Group 1 comprised 34 patients with favorable outcomes, while Group 2 included 31 patients with fatal outcomes.

Results: Significant differences were observed between the groups in terms of age (p = 0.01). Patients in Group 2 (with fatal outcomes) had a higher burden of co-morbidities, as measured by the Charlson Comorbidity Index (p = 0.00009) and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G; p = 0.000003). Additionally, the groups differed significantly in the number of days from disease onset to the initiation of biologic therapy (p = 0.02). In Group 2, delayed initiation of biologic therapy was associated with persistently high concentrations of acute-phase proteins.

Conclusions: Key factors influencing the efficacy of biologic therapy for severe COVID-19 with cytokine storm include patient age, the presence and severity of co-morbidities, and the timing of hospitalization and initiation of biologic therapy.

About the authors

Aleksandra V. Rogozhkina

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: gostevaaleksandra@gmail.com
ORCID iD: 0000-0003-4423-7408
SPIN-code: 4984-6618

MD

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015

Margarita N. Pogromskaya

North-Western State Medical University named after I.I. Mechnikov; Clinical Infectious Diseases Hospital named after S.P. Botkin

Email: M.Pogromskaya@szgmu.ru
ORCID iD: 0000-0001-8072-6589

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015; Saint Petersburg

Elena S. Romanova

North-Western State Medical University named after I.I. Mechnikov; Clinical Infectious Diseases Hospital named after S.P. Botkin

Email: E.Romanova@szgmu.ru
ORCID iD: 0000-0002-9887-8561
SPIN-code: 9435-6838

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015; Saint Petersburg

Galina Yu. Startseva

North-Western State Medical University named after I.I. Mechnikov; Clinical Infectious Diseases Hospital named after S.P. Botkin

Email: star661@rambler.ru
ORCID iD: 0000-0002-3660-2666
SPIN-code: 8392-2950

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015; Saint Petersburg

Olga M. Filipovich

North-Western State Medical University named after I.I. Mechnikov; Clinical Infectious Diseases Hospital named after S.P. Botkin

Email: filipowitch.olga@yandex.ru
ORCID iD: 0000-0001-9569-6941
SPIN-code: 3667-8214

MD

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015; Saint Petersburg

Margarita V. Klur

North-Western State Medical University named after I.I. Mechnikov

Email: rita-med@mail.ru
ORCID iD: 0009-0006-6222-2452

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015

Vsevolod M. Antonov

North-Western State Medical University named after I.I. Mechnikov

Email: Vsevolod.Antonov@szgmu.ru
ORCID iD: 0009-0002-3172-7926
SPIN-code: 9925-2139

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015

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Supplementary files

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2. Fig. 1. Distribution of used genetically engineered drugs in patients of groups 1 and 2

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3. Fig. 2. Dynamics of changes in lactate dehydrogenase levels in patients from groups 1 and 2

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4. Fig. 3. Dynamics of changes in the level of C-reactive protein in patients from groups 1 and 2

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5. Fig. 4. Dynamics of changes in the level of ferritin in patients from groups 1 and 2

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6. Fig. 5. Dynamics of changes in the level of D-dimer in patients from groups 1 and 2

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