生长激素治疗对身材矮小儿童新冠病毒易感性及严重程度的影响：一项孟德尔随机化分析的调查研究

The Impact of Growth Hormone Treatment on COVID-19 Susceptibility and Severity in Children with Short Stature: A Survey Study with Mendelian Randomization Analysis.

作者信息

Qiu Wenjuan, Wang Ruifang, Liang Lili, Sun Yuning, Zhou Rong, Wang Xiaoli, Sun Wen, Gu Xuefan

机构信息

Department of Pediatric Endocrinology and Genetic Metabolism, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai, 200092, People's Republic of China.

Medical Affairs, GeneScience Pharmaceuticals Co. Ltd. (Gensci), Shanghai, 200233, People's Republic of China.

出版信息

Infect Drug Resist. 2024 Dec 20;17:5675-5684. doi: 10.2147/IDR.S483477. eCollection 2024.

DOI:10.2147/IDR.S483477

PMID:39720618

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11668050/

Abstract

INTRODUCTION

Growth hormone (GH) is crucial for immune system development and regulation, potentially benefiting COVID-19 outcomes. However, there are limited studies on the role of GH treatment in COVID-19 in children with short stature.

METHODS

We conducted a survey study to evaluate the association between GH treatment and COVID-19 risk in short stature children aged 7 to 18 years. Two groups were defined: GH Treated and GH Untreated. The primary endpoint was the proportion of children with COVID-19 histories. Secondary endpoints included the presence, severity, and duration of COVID-19 symptoms. Exploratory endpoints included the frequency of common colds after GH treatment. We further performed two-sample Mendelian randomization (MR) analyses to explore the causal relationship between GH levels and COVID-19 susceptibility, hospitalization, and severity using genome-wide association study summary-level data.

RESULTS

Of the 201 children, 113 (56.2%) reported COVID-19 history, and 149 (74.1%) used GH. The mean age was 11.02 ± 2.10 years. GH treatment was associated with a somewhat lower proportion of COVID-19 history (-9.77%, 95% confidence interval [CI] -26.41% to 6.87%; P = 0.289), and the odds ratio (OR) is 0.58 (95% CI 0.29 to 1.14, P = 0.120) after adjusting for confounders. Among the 113 children with COVID-19 histories, the highest body temperature was significantly lower in the GH Treated group (P = 0.040). In the MR analyses, for one unit increase in GH level, the OR was 0.95 (95% CI 0.92 to 0.99, P = 0.022) for COVID-19 susceptibility, 0.86 (95% CI 0.77 to 0.96, P = 0.007) for COVID-19 hospitalization, and 0.95 (95% CI 0.84 to 1.07, P = 0.392) for COVID-19 severity.

CONCLUSION

GH treatment was associated with somewhat decreased COVID-19 susceptibility but was not statistically significant. Higher GH levels were causally associated with a significantly lower rate of COVID-19 susceptibility and hospitalization.

摘要

引言

生长激素（GH）对免疫系统的发育和调节至关重要，可能有益于新冠病毒病（COVID-19）的预后。然而，关于生长激素治疗对身材矮小儿童COVID-19的作用的研究有限。

方法

我们进行了一项调查研究，以评估7至18岁身材矮小儿童接受生长激素治疗与COVID-19风险之间的关联。定义了两组：接受生长激素治疗组和未接受生长激素治疗组。主要终点是有COVID-19病史的儿童比例。次要终点包括COVID-19症状的存在、严重程度和持续时间。探索性终点包括生长激素治疗后感冒的频率。我们进一步进行了两样本孟德尔随机化（MR）分析，以使用全基因组关联研究汇总水平数据探索生长激素水平与COVID-19易感性、住院率和严重程度之间的因果关系。

结果

在201名儿童中，113名（56.2%）报告有COVID-19病史，149名（74.1%）使用过生长激素。平均年龄为11.02±2.10岁。生长激素治疗与COVID-19病史比例略低相关（-9.77%，95%置信区间[CI]-26.41%至6.87%；P=0.289），调整混杂因素后优势比（OR）为0.58（95%CI0.29至1.14，P=0.120）。在113名有COVID-19病史的儿童中，接受生长激素治疗组的最高体温显著更低（P=0.040）。在MR分析中，生长激素水平每增加一个单位，COVID-19易感性的OR为0.95（95%CI0.92至0.99，P=0.022），COVID-19住院的OR为0.86（95%CI0.77至0.96，P=0.007），COVID-19严重程度的OR为0.95（95%CI0.84至1.07，P=0.392）。