The impact of Infliximab on mortality
rate of COVID-19
patients:
Our meta-analysis has revealed that Infliximab administration could
significantly decrease the mortality rate compared to non-infliximab
group in patients with SARS-CoV-2 infection.
According to Kokkotis et. al., meta-analysis, anti-TNFα treatment has
helpful effects in terms of reducing the risk of hospitalization and
severe COVID-19 in patients with underlying inflammatory disease
[16]. Tocilizumab, a kind of anti- TNFα which primarily used in
Rheumatoid disorders, could also decrease all-cause mortality in 6481
individuals with generally severe, non-critical COVID-19 infection based
on Avni et. al., meta-analysis [17]. Based on Halim et. al.,
meta-analysis, the mortality rate in COVID-19 patients is strongly
correlated with higher levels of serum concentrations of TNF-α. Each 1
picogram (pg)/mL surge in TNF-α level significantly increases the risk
of mortality rate in patients with COVID-19 according to this study
(with crude hazard ratio = 1.0640; 95% CI: 1.0259–1.1036; p = 0.0009)
[18]. Baricitinib, a Janus kinase (JAK) inhibitor primarily used in
moderate to severe active rheumatoid arthritis, could significantly
decrease the 28-day mortality rate of COVID-19 in hospitalized patients
rather than standard treatment (RR, 0.69, 95% CI, 0.50–0.94, p = 0.02,
i2 = 64.86%) [19]. According to Amstutz et. al., meta-analysis
remdesivir reduces the mortality rate in hospitalized patients with
COVID-19 who needed no or conventional respiratory oxygen support. In
this study, 662 (12·5%) of 5317 patients of remdesivir group and 706
(14·1%) of 5005 patients of no remdesivir group died (aOR 0·88, 95% CI
0·78-1·00, p=0·045). However, the results of the study were not
influential enough to recommend remdesivir for ventilated patients with
COVID-19 (aOR 1·10 [0·88-1·38]) [20].
According to Gohda et. al., study which utilized multivariate logistic
regression analysis, the mortality rate in patients with COVID-19 were
correlated with increased serum levels of TNFR1 and TNFR2 (p value =
0.08, p value = 0.03, respectively) [21]. Combination of Infliximab
with tocilizumab has superior therapeutic function rather than
tocilizumab alone in decreasing mortality rate and serum levels of
inflammatory factors in hospitalized patients with severe Covid-19
[22]. According to CLARITY study, levels of antibodies against
SARS-CoV-2 and anti- SARS-CoV-2 immune reactivity can be declined by
administration of Infliximab in patients with inflammatory bowel disease
(IBD) [23].