Transitions of blood immune endotypes and improved outcome by anakinra in COVID-19 pneumonia: an analysis of the SAVE-MORE randomized controlled trial
Authors' conclusion
We identify an association between endotypes defined using blood transcriptome and anakinra therapy for COVID-19 pneumonia, with anakinra-treated patients shifting toward endotypes associated with a better outcome, mainly the adaptive endotype.
Study context
- Population
- Adults hospitalised with PCR-confirmed severe SARS-CoV-2 pneumonia and plasma suPAR ≥ 6 ng/ml
- Participants
- 393 adults
- Comparison
- Anakinra vs placebo
- Primary endpoint
- Changes in blood immune endotypes (33-mRNA classifier) and progression to severe respiratory failure (SRF)
Primary result
As reported in the abstract
Endotypes and transitions
Inflammopathic at baseline
23.2%
Adaptive at baseline
41.1%
Coagulopathic at baseline
35.7%
Same endotype at days 4 and 7 as baseline; all others transitioned
23.9%
Further findings
Remaining in adaptive endotype during 7-day treatment
P < 0.001
SRF, coagulopathic endotype at day 7 (subgroup)
P = 0.013
Original publication
Transitions of blood immune endotypes and improved outcome by anakinra in COVID-19 pneumonia: an analysis of the SAVE-MORE randomized controlled trial. Crit Care. Published 12 March 2024. doi:10.
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