Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Department of Health Sciences & Technology, ETH Zurich, 8603 Zurich, Switzerland.
Viruses. 2020 Dec 30;13(1):44. doi: 10.3390/v13010044.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes coronavirus disease 2019 (COVID-19), a lung disease that may progress to systemic organ involvement and in some cases, death. The identification of the earliest predictors of progressive lung disease would allow for therapeutic intervention in those cases. In an earlier clinical study, individuals with moderate COVID-19 were treated with either arbidol (ARB) or inhaled interferon (IFN)-α2b +/-ARB. IFN treatment resulted in accelerated viral clearance from the upper airways and in a reduction in the circulating levels of the inflammatory biomarkers IL-6 and C-reactive protein (CRP). We have extended the analysis of this study cohort to determine whether IFN treatment had a direct effect on virus-induced lung abnormalities and also to ascertain whether any clinical or immune parameters are associated with worsening of lung abnormalities. Evidence is provided that IFN-α2b treatment limits the development of lung abnormalities associated with COVID-19, as assessed by CT images. Clinical predictors associated with worsening of lung abnormalities include low CD8+ T cell numbers, low levels of circulating albumin, high numbers of platelets, and higher levels of circulating interleukin (IL)-10, IL-6, and C-reactive protein (CRP). Notably, in this study cohort, IFN treatment resulted in a higher percentage of CD8+ T cells, lower tumor necrosis factor (TNF)-α levels and, as reported earlier, lower IL-6 levels. Independent of treatment, age and circulating levels of albumin and CRP emerged as the strongest predictors of the severity of lung abnormalities.
严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染导致 2019 年冠状病毒病 (COVID-19),这是一种肺部疾病,可能进展为全身器官受累,在某些情况下导致死亡。识别进行性肺病的最早预测因子将允许在这些情况下进行治疗干预。在早期的临床研究中,中度 COVID-19 患者接受利巴韦林 (ARB) 或吸入干扰素 (IFN)-α2b +/-ARB 治疗。IFN 治疗可加速上呼吸道病毒清除,并降低循环中炎症生物标志物白细胞介素 6 (IL-6) 和 C 反应蛋白 (CRP) 的水平。我们扩展了这项研究队列的分析,以确定 IFN 治疗是否对病毒引起的肺部异常有直接影响,以及是否有任何临床或免疫参数与肺部异常的恶化相关。有证据表明,IFN-α2b 治疗可限制 COVID-19 相关肺部异常的发展,这通过 CT 图像评估。与肺部异常恶化相关的临床预测因子包括 CD8+T 细胞数量低、循环白蛋白水平低、血小板数量高,以及循环白细胞介素 (IL)-10、IL-6 和 CRP 水平高。值得注意的是,在本研究队列中,IFN 治疗导致 CD8+T 细胞比例增加,肿瘤坏死因子 (TNF)-α 水平降低,如前所述,IL-6 水平降低。独立于治疗,年龄和循环白蛋白和 CRP 水平是肺部异常严重程度的最强预测因子。