COVID-19 patients with severe pneumonia treated with leukotriene inhibitors are more likely to survive

Researchers from the University of Buffalo in Biomedical Informatics found that patients hospitalized with COVID-19 pneumonia had a 13.5% survival advantage when treated with a combination of leukotriene inhibitors (LTI) and dexamethasone steroids.

“It’s retrospective study demonstrates efficiency of use big data to achieve important clinical advances, ”said Peter L. Elkin, MD, first author of the study, professor and chair of the Department of Medical Informatics at the Jacobs School of Medicine and Biomedical Sciences at UB and a researcher at the Department of Veterans Affairs.

“Although promising clinical studies are needed to confirm these retrospective findings of big data, our study suggests that LTIs are a promising new therapy for severe COVID-19 infection,” he said.

Research shows that patients with low oxygen saturation, treated with leukotriene inhibitors in addition to dexamethasone, have a 13.5% advantage in inpatient survival in COVID-19 infection. Patients taking LTI prior to hospitalization who continued to take LTI had a 22% survival advantage.

“This is a new treatment with very strong results that should save lives in general,” said Elkin, who takes patients through UBMD Internal Medicine and the VA Western New York Healthcare System.

The newspaper was published on May 16 Journal of Clinical and Translational Sciences.

13.5% advantage in survival was found in severe patients with 50% or less oxygen saturation.

The researchers also found that treating critically ill patients with COVID-19 with dexamethasone alone had no beneficial effect on mortality or disease.

The study’s motivation stemmed from observations at the start of the pandemic that patients with COVID-19 died from acute respiratory distress syndrome (ARDS), a type of lung failure.

“I knew that IL6 and IL8 (interleukins 6 and 8) are poor prognostic indicators in ORDS,” Elkin said. “I also knew that leukotriene inhibitors reduce them inflammatory mediatorstherefore, we have suggested that they may be useful in reducing mortality and morbidity in COVID-19 pneumonia. ”

Patients receiving LTI had lower levels of inflammation and the “cytokine storm” observed with COVID-19 pneumonia.

The researchers used the Department of Veterans Affairs’s (VA) Corporate Data Warehouse to create a cohort of COVID-19-positive patients and tracked the use of leukotriene inhibitors in combination with dexamethasone from November 1, 2019, to November 11, 2021.

Patients in the study who had asthma and who were found to be at higher risk of severe COVID-19 outcomes were better on LTI and dexamethasone than patients with asthma who were not treated with these drugs.

Elkin noted that patients who received the combination of LTI and dexamethasone were generally more compromised than patients who were not treated with this combination.

“This makes it likely that our detection of a 13.5% survival improvement is an underestimation of the true effect, as LTI users generally had more comorbidities than patients who were not treated with LTI,” he said.

Measured inflammatory markers, such as IL6, were reduced in the LTI cohort.

The number of LTI users and non-LTI users who received at least one vaccination was about the same – about 9% and 9.3%.

The corporate data repository provided to VA researchers was an invaluable resource, Elkin said.

“VA’s massive data set of electronic medical records is a gold mine for understanding real-world data to improve clinical care and improving the health of our patients, ”he said.