tetano
Editor, Senior Moderator
BMC Pulm Med
. 2026 Jun 23.
doi: 10.1186/s12890-026-04406-9. Online ahead of print.
Efficacy and optimal timing of sivelestat in critically ill patients with COVID-19: a multicenter retrospective cohort study
Qi Zhang[SUP] 1 2 [/SUP], Yijie Liu[SUP] 2 [/SUP], Bowen Ran[SUP] 2 3 4 [/SUP], Tianshu Zhai[SUP] 2 [/SUP], Ying Cai[SUP] 2 [/SUP], Chao Zhang[SUP] 2 5 [/SUP], Jingcheng Hao[SUP] 6 [/SUP], Longxian Jin[SUP] 1 2 [/SUP], Zhenyuan Huang[SUP] 1 2 [/SUP], Xiaojing Wu[SUP] #[/SUP][SUP] 7 8 [/SUP], Qingyuan Zhan[SUP] #[/SUP][SUP] 9 10 [/SUP]
Affiliations
Background: The cytokine storm is a pivotal factor in the progression of coronavirus disease 2019 (COVID-19) to severe disease. Sivelestat, recognized for its anti-inflammatory properties, holds promise as a therapeutic intervention for patients with severe COVID-19.
Methods: We conducted a multicenter, retrospective study involving patients admitted to the intensive care unit (ICU) with severe COVID-19 in China. A 1:2 propensity score matching (PSM) was employed to adjust for confounding factors and differences between the sivelestat and non-sivelestat groups.
Results: Our analysis involved 2030 patients with severe COVID-19. After applying a 1:2 PSM ratio, the sivelestat group consisted of 115 patients, while the non-sivelestat group comprised 211 patients. The findings indicated that sivelestat administration was associated with enhanced survival rates at 28 days for patients with severe COVID-19 (53.55% vs. 40.87%; P = 0.03). However, no significant differences were noted in the secondary outcomes, which included ventilator-free days within 28 days, gastrointestinal bleeding, septic shock, acute myocardial injury, venous thrombosis, acute liver injury, and acute kidney injury. Furthermore, this study revealed that early administration of sivelestat could reduce patient mortality.
Conclusions: Our study suggests that sivelestat use may be associated with reduced 28-day mortality in ICU patients with severe COVID-19.
Keywords: ICU; Prognosis; Propensity score matching; Severe COVID-19; Sivelestat.
. 2026 Jun 23.
doi: 10.1186/s12890-026-04406-9. Online ahead of print.
Efficacy and optimal timing of sivelestat in critically ill patients with COVID-19: a multicenter retrospective cohort study
Qi Zhang[SUP] 1 2 [/SUP], Yijie Liu[SUP] 2 [/SUP], Bowen Ran[SUP] 2 3 4 [/SUP], Tianshu Zhai[SUP] 2 [/SUP], Ying Cai[SUP] 2 [/SUP], Chao Zhang[SUP] 2 5 [/SUP], Jingcheng Hao[SUP] 6 [/SUP], Longxian Jin[SUP] 1 2 [/SUP], Zhenyuan Huang[SUP] 1 2 [/SUP], Xiaojing Wu[SUP] #[/SUP][SUP] 7 8 [/SUP], Qingyuan Zhan[SUP] #[/SUP][SUP] 9 10 [/SUP]
Affiliations
- PMID: 42337706
- DOI: 10.1186/s12890-026-04406-9
Background: The cytokine storm is a pivotal factor in the progression of coronavirus disease 2019 (COVID-19) to severe disease. Sivelestat, recognized for its anti-inflammatory properties, holds promise as a therapeutic intervention for patients with severe COVID-19.
Methods: We conducted a multicenter, retrospective study involving patients admitted to the intensive care unit (ICU) with severe COVID-19 in China. A 1:2 propensity score matching (PSM) was employed to adjust for confounding factors and differences between the sivelestat and non-sivelestat groups.
Results: Our analysis involved 2030 patients with severe COVID-19. After applying a 1:2 PSM ratio, the sivelestat group consisted of 115 patients, while the non-sivelestat group comprised 211 patients. The findings indicated that sivelestat administration was associated with enhanced survival rates at 28 days for patients with severe COVID-19 (53.55% vs. 40.87%; P = 0.03). However, no significant differences were noted in the secondary outcomes, which included ventilator-free days within 28 days, gastrointestinal bleeding, septic shock, acute myocardial injury, venous thrombosis, acute liver injury, and acute kidney injury. Furthermore, this study revealed that early administration of sivelestat could reduce patient mortality.
Conclusions: Our study suggests that sivelestat use may be associated with reduced 28-day mortality in ICU patients with severe COVID-19.
Keywords: ICU; Prognosis; Propensity score matching; Severe COVID-19; Sivelestat.