Zhu Meng-En, Wang Qian, Zhou Shaoqiong, Wang Bin, Ke Li, He Ping
Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.
Exp Ther Med. 2021 Mar;21(3):227. doi: 10.3892/etm.2021.9658. Epub 2021 Jan 18.
A recently identified type of pneumonia, referred to as coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2, has rapidly spread worldwide. Lymphopenia and a proinflammatory cytokine storm frequently occur in patients with severe COVID-19. However, to the best of our knowledge, no specific immunomodulatory therapy for COVID-19 has been reported to date. In the present retrospective case-control study, the potential therapeutic effect of recombinant human interleukin-2 (rIL-2) in patients with severe COVID-19 was demonstrated. A total of 59 patients with severe COVID-19 were admitted to the Union Hospital of Tongji Medical College (Wuhan, China) between 29th January 2020 and 29th February 2020 and were included in the present study. In total, 20 patients received subcutaneous injection of rIL-2 (1 million IU per day) for 7-10 days in addition to regular treatment and were classified as the rIL-2 group. Furthermore, 20 of the 39 patients receiving regular treatment, without the intervention of rIL-2, were matched as the control group. Patients in these two groups were subjected to propensity score matching in terms of clinical characteristics such as age, sex, symptoms, signs, laboratory data and comorbidities. Changes in the lymphocyte count, as well as IL-6 and C-reactive protein (CRP) levels, were analyzed at the time of admission and discharge and any differences between the rIL-2 and non-rIL-2 groups were determined. The results demonstrated an increase in the lymphocyte count and a decrease in CRP levels in the rIL-2 group compared with that in the non-rIL-2 group. The difference in the change of the lymphocyte count between the rIL-2 group and non-rIL-2 group was statistically significant (P<0.01). Although CRP levels were decreased to a greater extent in the rIL-2 group, the difference between the two groups was not statistically significant (P>0.05). Collectively, the present results suggested that administration of rIL-2 may be a prospective adjuvant therapy for patients with severe COVID-19 and its effects may be mediated by increasing lymphocyte numbers.
一种最近被确认的肺炎类型,称为2019冠状病毒病(COVID-19),由严重急性呼吸综合征冠状病毒2引起,已在全球迅速传播。淋巴细胞减少和促炎细胞因子风暴在重症COVID-19患者中经常出现。然而,据我们所知,迄今为止尚未报道针对COVID-19的特异性免疫调节疗法。在本回顾性病例对照研究中,证实了重组人白细胞介素-2(rIL-2)对重症COVID-19患者的潜在治疗效果。2020年1月29日至2月29日期间,共有59例重症COVID-19患者被收入华中科技大学同济医学院附属协和医院(中国武汉)并纳入本研究。总共20例患者除接受常规治疗外,还接受皮下注射rIL-2(每天100万国际单位),持续7至10天,并被分类为rIL-2组。此外,在39例接受常规治疗、未接受rIL-2干预的患者中,选取20例作为对照组。对这两组患者在年龄、性别、症状、体征、实验室数据和合并症等临床特征方面进行倾向得分匹配。在入院时和出院时分析淋巴细胞计数以及白细胞介素-6和C反应蛋白(CRP)水平的变化,并确定rIL-2组和非rIL-2组之间的任何差异。结果显示,与非rIL-2组相比,rIL-2组的淋巴细胞计数增加,CRP水平降低。rIL-2组和非rIL-2组之间淋巴细胞计数变化的差异具有统计学意义(P<0.01)。虽然rIL-2组的CRP水平下降幅度更大,但两组之间的差异无统计学意义(P>0.05)。总体而言,目前的结果表明,给予rIL-2可能是重症COVID-19患者的一种前瞻性辅助治疗方法,其效果可能通过增加淋巴细胞数量来介导。