Clinical evidence of an interferon-glucocorticoid therapeutic synergy in COVID-19.

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Abstrakt

Tytuł:: Clinical evidence of an interferon-glucocorticoid therapeutic synergy in COVID-19.
Autorzy:: Lu Y; Department of Biomedical Science, Shenzhen Research Institute, City University of Hong Kong, Kowloon Tong, Hong Kong, China.; Department of Nephrology, Center of Nephrology and Urology, Sun Yat-sen University Seventh Hospital, Shenzhen, Guangdong, China.
Liu F; Department of Infectious Diseases, Suizhou Zengdu Hospital, Suizhou, Hubei, China.
Tong G; Department of Oncology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
Qiu F; Department of Infectious Diseases, Suizhou Zengdu Hospital, Suizhou, Hubei, China.
Song P; Department of Infectious Diseases, Suizhou Zengdu Hospital, Suizhou, Hubei, China.
Wang X; Intensive Care Unit, Suizhou Zengdu Hospital, Suizhou, Hubei, China.
Zou X; Intensive Care Unit, Suizhou Zengdu Hospital, Suizhou, Hubei, China.
Wan D; Department of Respiratory Medicine, Suizhou Zengdu Hospital, Suizhou, Hubei, China.
Cui M; Department of Pathology, Mount Sinai St. Luke's Roosevelt Hospital Center, New York, NY, USA.
Xu Y; Department of Dermatology, Sun Yat-sen University Seventh Hospital, Shenzhen, Guangdong, China.
Zheng Z; Department of Nephrology, Center of Nephrology and Urology, Sun Yat-sen University Seventh Hospital, Shenzhen, Guangdong, China.
Hong P; Department of Nephrology, Center of Nephrology and Urology, Sun Yat-sen University Seventh Hospital, Shenzhen, Guangdong, China. .; Division of Research and Development, US Department of Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY, USA. .; Department of Cell Biology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA. .
Źródło:: Signal transduction and targeted therapy [Signal Transduct Target Ther] 2021 Mar 03; Vol. 6 (1), pp. 107. Date of Electronic Publication: 2021 Mar 03.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
Język:: English
Imprint Name(s):: Original Publication: [London] : Nature Publishing Group, [2016]-
MeSH Terms:: SARS-CoV-2*
COVID-19 Drug Treatment*
Dexamethasone/*administration & dosage
Interferons/*administration & dosage
Adult ; COVID-19/diagnosis ; COVID-19/mortality ; COVID-19 Nucleic Acid Testing ; Dexamethasone/agonists ; Drug Synergism ; Female ; Humans ; Interferons/agonists ; Male ; Middle Aged ; Retrospective Studies
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Grant Information:: 5I01BX001353 U.S. Department of Veterans Affairs (Department of Veterans Affairs); 31501116 National Natural Science Foundation of China (National Science Foundation of China); JCYJ20190809100005672 Shenzhen Science and Technology Innovation Commission; SZSM201911013 Shenzhen Science and Technology Innovation Commission
Substance Nomenclature:: 7S5I7G3JQL (Dexamethasone)
9008-11-1 (Interferons)
Entry Date(s):: Date Created: 20210304 Date Completed: 20210322 Latest Revision: 20221207
Update Code:: 20240105
PubMed Central ID:: PMC7925812
DOI:: 10.1038/s41392-021-00496-5
PMID:: 33658482
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Synthetic glucocorticoid dexamethasone is the first trial-proven drug that reduces COVID-19 mortality by suppressing immune system. In contrast, interferons are a crucial component of host antiviral immunity and can be directly suppressed by glucocorticoids. To investigate whether therapeutic interferons can compensate glucocorticoids-induced loss of antiviral immunity, we retrospectively analyzed a cohort of 387 PCR-confirmed COVID-19 patients with quasi-random exposure to interferons and conditional exposure to glucocorticoids. Among patients receiving glucocorticoids, early interferon therapy was associated with earlier hospital discharge (adjusted HR 1.68, 95% CI 1.19-2.37) and symptom relief (adjusted HR 1.48, 95% CI 1.06-2.08), while these associations were insignificant among glucocorticoids nonusers. Early interferon therapy was also associated with lower prevalence of prolonged viral shedding (adjusted OR 0.24, 95% CI 0.10-0.57) only among glucocorticoids users. Additionally, these associations were glucocorticoid cumulative dose- and timing-dependent. These findings reveal potential therapeutic synergy between interferons and glucocorticoids in COVID-19 that warrants further investigation.

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