Ayman Chkhis, Najiba Abdulrazzaq, Sherif Mokhtar, Alia Al Jasmi
{"title":"大剂量雾化干扰素α 2b治疗重症COVID-19肺炎的疗效观察","authors":"Ayman Chkhis, Najiba Abdulrazzaq, Sherif Mokhtar, Alia Al Jasmi","doi":"10.5152/TurkThoracJ.2021.20255","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The COVID-19 pandemic is progressing rapidly, sending the world into a great panic. Healthcare professionals have responded by embarking on a concerted search for therapies to cure and prevent COVID-19. Recently, interferon (IFN) has emerged as a potential therapy as it is associated with reducing lung inflammation and suppressing viral replication. This research paper assessed the efficacy of high-dose nebulized IFN α 2b in severe COVID-19 pneumonia.</p><p><strong>Methods: </strong>This is a retrospective study. It commenced on April 9 and ended on June 17, 2020. Researchers selected participants from hospitalized patients aged 18 years and above who were diagnosed with severe COVID-19 pneumonia. Other inclusion criteria were bilateral pneumonia on lung or chest X-ray scan and severe respiratory distress. SMART-COP, which is a risk stratification scoring tool, and radiologic severity index (RSI) were used to assess pneumonia severity. Patients in the treatment cohort received nebulized IFN α 2b at a dose of 10 million IU every 12 hours for 5 days, in addition to standard treatment. Patients in the control cohort received standard treatment only.</p><p><strong>Results: </strong>Seventy-three patients met the inclusion criteria; 37 were included in the treatment cohort and 36 in the control cohort. Mechanical ventilation was needed in 14 of 36 (38.9%) patients in the control cohort, compared with 6 of 37 (27.4%) patients in the treatment cohort (HR 5.62 [95% CI 1.81-17.48]; P = .003). For pneumonia severity, there was a hazard ratio (HR) of 3.72 [95% CI 1.74- 7.98]; P = ·.01. After 5 days of treatment, chest X-rays indicated significant beneficial changes in the treatment group (HR 2.24 [CI 1.05-4.79]; P = .036). Multivariate analysis revealed that pneumonia severity and RSI remained higher in the control group. The HR was 3.44 [95% CI 1.49-7.94]; P = .004 and 2.26 [95% CI 0.99-5.16]; P = .05, respectively. There was an increase in liver aminotransferases in 5 (14%) participants in the control cohort and 3 (8%) participants in the treatment cohort.</p><p><strong>Conclusion: </strong>High-dose nebulized IFN α 2b has potential efficacy in mitigating severe COVID-19 pneumonia. This study established that administering high-dose nebulized IFN α 2b significantly reduces pneumonia severity in COVID-19 patients. We also found a strong relationship between using nebulized IFN α 2b and reduced need for mechanical ventilation among patients with severe COVID-19 pneumonia. However, a well-designed control trial is needed to confirm the drug's efficacy in reducing the COVID-19 pneumonia severity.</p>","PeriodicalId":37452,"journal":{"name":"Turkish Thoracic Journal","volume":"22 3","pages":"199-204"},"PeriodicalIF":0.8000,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8975308/pdf/ttj-22-3-199.pdf","citationCount":"2","resultStr":"{\"title\":\"Efficacy of High-Dose Nebulized Interferon α 2b in Severe COVID-19 Pneumonia.\",\"authors\":\"Ayman Chkhis, Najiba Abdulrazzaq, Sherif Mokhtar, Alia Al Jasmi\",\"doi\":\"10.5152/TurkThoracJ.2021.20255\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The COVID-19 pandemic is progressing rapidly, sending the world into a great panic. Healthcare professionals have responded by embarking on a concerted search for therapies to cure and prevent COVID-19. Recently, interferon (IFN) has emerged as a potential therapy as it is associated with reducing lung inflammation and suppressing viral replication. This research paper assessed the efficacy of high-dose nebulized IFN α 2b in severe COVID-19 pneumonia.</p><p><strong>Methods: </strong>This is a retrospective study. It commenced on April 9 and ended on June 17, 2020. Researchers selected participants from hospitalized patients aged 18 years and above who were diagnosed with severe COVID-19 pneumonia. Other inclusion criteria were bilateral pneumonia on lung or chest X-ray scan and severe respiratory distress. SMART-COP, which is a risk stratification scoring tool, and radiologic severity index (RSI) were used to assess pneumonia severity. Patients in the treatment cohort received nebulized IFN α 2b at a dose of 10 million IU every 12 hours for 5 days, in addition to standard treatment. Patients in the control cohort received standard treatment only.</p><p><strong>Results: </strong>Seventy-three patients met the inclusion criteria; 37 were included in the treatment cohort and 36 in the control cohort. Mechanical ventilation was needed in 14 of 36 (38.9%) patients in the control cohort, compared with 6 of 37 (27.4%) patients in the treatment cohort (HR 5.62 [95% CI 1.81-17.48]; P = .003). For pneumonia severity, there was a hazard ratio (HR) of 3.72 [95% CI 1.74- 7.98]; P = ·.01. After 5 days of treatment, chest X-rays indicated significant beneficial changes in the treatment group (HR 2.24 [CI 1.05-4.79]; P = .036). Multivariate analysis revealed that pneumonia severity and RSI remained higher in the control group. The HR was 3.44 [95% CI 1.49-7.94]; P = .004 and 2.26 [95% CI 0.99-5.16]; P = .05, respectively. 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引用次数: 2
摘要
目的:当前新冠肺炎疫情快速蔓延,全球陷入巨大恐慌。医疗保健专业人员已经开始协调一致地寻找治疗和预防COVID-19的疗法。最近,干扰素(IFN)已成为一种潜在的治疗方法,因为它与减少肺部炎症和抑制病毒复制有关。本研究评价了大剂量雾化IFN α 2b治疗COVID-19重症肺炎的疗效。方法:回顾性研究。从2020年4月9日开始,到6月17日结束。研究人员从18岁及以上被诊断为COVID-19严重肺炎的住院患者中选择了参与者。其他入选标准为肺或胸部x线扫描双侧肺炎和严重呼吸窘迫。使用风险分层评分工具SMART-COP和放射严重程度指数(RSI)评估肺炎严重程度。治疗组患者在标准治疗的基础上,以每12小时1000万IU的剂量雾化IFN α 2b,持续5天。对照组患者仅接受标准治疗。结果:73例患者符合纳入标准;37人被纳入治疗组,36人被纳入对照组。对照组36例患者中有14例(38.9%)需要机械通气,而治疗组37例患者中有6例(27.4%)需要机械通气(HR 5.62 [95% CI 1.81-17.48];P = .003)。肺炎严重程度的风险比(HR)为3.72 [95% CI 1.74- 7.98];P =·0.01。治疗5天后,胸部x光片显示治疗组有明显的有益变化(HR 2.24 [CI 1.05-4.79];P = .036)。多因素分析显示,对照组的肺炎严重程度和RSI仍然较高。风险比为3.44 [95% CI 1.49 ~ 7.94];P = 0.004和2.26 [95% CI 0.99-5.16];P = 0.05。对照组中有5人(14%)肝转氨酶升高,治疗组中有3人(8%)肝转氨酶升高。结论:大剂量IFN α 2b雾化治疗COVID-19重症肺炎具有潜在疗效。本研究证实,给予大剂量雾化IFN α 2b可显著降低COVID-19患者肺炎严重程度。我们还发现,在COVID-19重症肺炎患者中,使用雾化IFN α 2b与减少机械通气需求之间存在密切关系。然而,为了证实药物降低COVID-19肺炎严重程度的有效性,需要进行精心设计的对照试验。
Efficacy of High-Dose Nebulized Interferon α 2b in Severe COVID-19 Pneumonia.
Objective: The COVID-19 pandemic is progressing rapidly, sending the world into a great panic. Healthcare professionals have responded by embarking on a concerted search for therapies to cure and prevent COVID-19. Recently, interferon (IFN) has emerged as a potential therapy as it is associated with reducing lung inflammation and suppressing viral replication. This research paper assessed the efficacy of high-dose nebulized IFN α 2b in severe COVID-19 pneumonia.
Methods: This is a retrospective study. It commenced on April 9 and ended on June 17, 2020. Researchers selected participants from hospitalized patients aged 18 years and above who were diagnosed with severe COVID-19 pneumonia. Other inclusion criteria were bilateral pneumonia on lung or chest X-ray scan and severe respiratory distress. SMART-COP, which is a risk stratification scoring tool, and radiologic severity index (RSI) were used to assess pneumonia severity. Patients in the treatment cohort received nebulized IFN α 2b at a dose of 10 million IU every 12 hours for 5 days, in addition to standard treatment. Patients in the control cohort received standard treatment only.
Results: Seventy-three patients met the inclusion criteria; 37 were included in the treatment cohort and 36 in the control cohort. Mechanical ventilation was needed in 14 of 36 (38.9%) patients in the control cohort, compared with 6 of 37 (27.4%) patients in the treatment cohort (HR 5.62 [95% CI 1.81-17.48]; P = .003). For pneumonia severity, there was a hazard ratio (HR) of 3.72 [95% CI 1.74- 7.98]; P = ·.01. After 5 days of treatment, chest X-rays indicated significant beneficial changes in the treatment group (HR 2.24 [CI 1.05-4.79]; P = .036). Multivariate analysis revealed that pneumonia severity and RSI remained higher in the control group. The HR was 3.44 [95% CI 1.49-7.94]; P = .004 and 2.26 [95% CI 0.99-5.16]; P = .05, respectively. There was an increase in liver aminotransferases in 5 (14%) participants in the control cohort and 3 (8%) participants in the treatment cohort.
Conclusion: High-dose nebulized IFN α 2b has potential efficacy in mitigating severe COVID-19 pneumonia. This study established that administering high-dose nebulized IFN α 2b significantly reduces pneumonia severity in COVID-19 patients. We also found a strong relationship between using nebulized IFN α 2b and reduced need for mechanical ventilation among patients with severe COVID-19 pneumonia. However, a well-designed control trial is needed to confirm the drug's efficacy in reducing the COVID-19 pneumonia severity.
期刊介绍:
Turkish Thoracic Journal (Turk Thorac J) is the double-blind, peer-reviewed, open access, international publication organ of Turkish Thoracic Society. The journal is a quarterly publication, published on January, April, July, and October and its publication language is English. Turkish Thoracic Journal started its publication life following the merger of two journals which were published under the titles “Turkish Respiratory Journal” and “Toraks Journal” until 2007. Archives of both journals were passed on to the Turkish Thoracic Journal. The aim of the journal is to convey scientific developments and to create a dynamic discussion platform about pulmonary diseases. With this intent, the journal accepts articles from all related scientific areas that address adult and pediatric pulmonary diseases, as well as thoracic imaging, environmental and occupational disorders, intensive care, sleep disorders and thoracic surgery. Clinical and research articles, reviews, statements of agreement or disagreement on controversial issues, national and international consensus reports, abstracts and comments of important international articles, interesting case reports, writings related to clinical and practical applications, letters to the editor, and editorials are accepted.