{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T02:45:42Z","timestamp":1774406742933,"version":"3.50.1"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T00:00:00Z","timestamp":1641254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>There is a need for treatments to reduce coronavirus disease 2019 (COVID-19) mortality. Alpha-2 adrenergic receptor (\u03b1<jats:sub>2<\/jats:sub> AR) agonists can dampen immune cell and inflammatory responses as well as improve oxygenation through physiologic respiratory parameters. Therefore, \u03b1<jats:sub>2<\/jats:sub> AR agonists may be effective in reducing mortality related to hyperinflammation and acute respiratory failure in COVID-19. Dexmedetomidine (DEX) is an \u03b1<jats:sub>2<\/jats:sub> AR agonist used for sedation. We performed a retrospective analysis of adults at Rush University System for Health hospitals between March 1, 2020 and July 30, 2020 with COVID-19 requiring invasive mechanical ventilation and sedation (<jats:italic>n<\/jats:italic> = 214). We evaluated the association of DEX use and 28-day mortality from time of intubation. Overall, 28-day mortality in the cohort receiving DEX was 27.0% as compared to 64.5% in the cohort that did not receive DEX (relative risk reduction 58.2%; 95% CI 42.4\u201369.6). Use of DEX was associated with reduced 28-day mortality on multivariable Cox regression analysis (aHR 0.19; 95% CI 0.10\u20130.33; <jats:italic>p<\/jats:italic> &amp;lt; 0.001). Adjusting for time-varying exposure to DEX also demonstrated that DEX was associated with reduced 28-day mortality (aHR 0.51; 95% CI 0.28\u20130.95; <jats:italic>p<\/jats:italic> = 0.03). Earlier DEX use, initiated &amp;lt;3.4 days from intubation, was associated with reduced 28-day mortality (aHR 0.25; 95% CI 0.13\u20130.50; <jats:italic>p<\/jats:italic> &amp;lt; 0.001) while later DEX use was not (aHR 0.64; 95% CI 0.27\u20131.50; <jats:italic>p<\/jats:italic> = 0.30). These results suggest an \u03b1<jats:sub>2<\/jats:sub> AR agonist might reduce mortality in patients with COVID-19. Randomized controlled trials are needed to confirm this observation.<\/jats:p>","DOI":"10.3389\/fmed.2021.797647","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T08:07:29Z","timestamp":1641283649000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["The Association of an Alpha-2 Adrenergic Receptor Agonist and Mortality in Patients With COVID-19"],"prefix":"10.3389","volume":"8","author":[{"given":"John L.","family":"Hamilton","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Vashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekta B.","family":"Kishen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis F.","family":"Fogg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus A.","family":"Wimmer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Balk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,1,4]]},"reference":[{"key":"B1","volume-title":"COVID-19 Dashboard","year":"2020"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1446","DOI":"10.3389\/fimmu.2020.01446","article-title":"The COVID-19 cytokine storm; 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