Effect of Urinary Trypsin Inhibitor (Ulinastatin) Therapy in COVID-19

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Anand Jain
2. Rohit Jain
3. Priyamvada Gupta
4. Divyansh Gupta
5. Rajeev Kasliwal
6. Rohan Tambi
7. Srishti Suresh Jain
8. Munesh Meena
9. Puneet Panwar
10. Ravi Jain
ISSN
0972-5229
DOI
10.5005/jp-journals-10071-24156
Volume
26
Issue
6
Publishing Year
2022
Pages
8
Author Affiliations
    1. Department of Endocrinology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
    1. Critical Care, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
    1. Agra, Uttar Pradesh, India
    2. Insignia Communications Pvt. Ltd., Mumbai, Maharashtra, India
    1. Department of Critical Care Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
    1. Department of Anesthesiology, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
    1. Department of Critical Care Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
    1. Critical Care Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
    1. Critical Care Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
    1. Critical Care Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
    1. Critical Care Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
  • Article keywords
    Anti-inflammatory therapy, COVID-19, Cytokine storm, Immune modulation therapy, Retrospective study, Ulinastatin, Urinary trypsin inhibitor therapy

    Abstract

    Purpose: End-organ damage in coronavirus disease-2019 (COVID-19) is linked to “cytokine storm” and excessive release of inflammatory mediators. Various novel therapies have been used in COVID-19 including urinary trypsin inhibitor therapy. This study explores the efficacy of ulinastatin in COVID-19. Materials and methods: We retrieved the medical records of patients admitted during one month and did a propensity score analysis to create matched treatment and control groups. We analyzed these groups and the outcomes were presented with appropriate statistics. Survival curve was prepared to compare the survival effect of ulinastatin therapy at the end of hospitalization, among both the groups. Results: A total of 736 patients were admitted, and after adjusting the data with propensity score matching, 55 cases were selected by the system. On the final outcome analysis, we found that intensive care unit (ICU) length of stay [median (interquartile range) days 3 (3.5–7.8) vs 2 (0-4); p-value 0.28] in control vs intervention groups, and in hospital mortality (odds ratio: 0.491, CI 95%: 0.099–2.44, p-value 0.435) were not statistically different among the groups. In survival plot analysis also, there was no statistical difference (p-value 0.414) among both the groups.Conclusion: In this retrospective study, we conclude that the final outcome of the ICU length of stay, and overall, in hospital mortality were not different among both the groups. Hence, adequately powered randomized control trials are urgently required to confirm any benefit of ulinastatin therapy in COVID-19 treatment.

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