Serum cytokine levels of COVID-19 patients after 7 days of treatment with Favipiravir or Kaletra,International Immunopharmacology

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Serum cytokine levels of COVID-19 patients after 7 days of treatment with Favipiravir or Kaletra
International Immunopharmacology ( IF 5.6 ) Pub Date : 2021-01-22 , DOI: 10.1016/j.intimp.2021.107407
Esmaeil Mortaz ₁ , Ali Bassir ₂ , Neda Dalil Roofchayee ₃ , Neda K Dezfuli ₃ , Hamidreza Jamaati ₄ , Payam Tabarsi ₅ , Afshin Moniri ₅ , Mitra Rezaei ₅ , Payam Mehrian ₄ , Mohammad Varahram ₄ , Majid Marjani ₅ , Sharon Mumby ₆ , Ian M Adcock ₇

Affiliation

Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, CA, USA.
Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
National Heart and Lung Institute, Imperial College London and the NIHR Imperial Biomedical Research Centre, London, UK.
National Heart and Lung Institute, Imperial College London and the NIHR Imperial Biomedical Research Centre, London, UK; Priority Research Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has infected 86,4M patients and resulted in 1,86M deaths worldwide. Severe COVID-19 patients have elevated blood levels of interleukin-6 (IL-6), IL-1β, tumor necrosis factor (TNF)α, CXCL8 and interferon (IFN)γ.

Objective

To investigate the effect of antiviral treatment serum cytokines in severe COVID-19 patients.

Methods

Blood was obtained from 29 patients (aged 32-79yr) with laboratory-confirmed COVID-19 upon admission and 7 days after antiviral (Favipiravir or Lopinavir/Ritonavir) treatment. Patients also received standard supportive treatment in this retrospective observational study. Chest computed tomography (CT) scans were evaluated to investigate lung manifestations of COVID-19. Serum was also obtained and cytokines levels were evaluated. 19 age- and gender-matched healthy controls were studied.

Results

Anti-viral therapy significantly reduced CT scan scores and the elevated serum levels of C-reactive protein (CRP) and lactate dehydrogenase (LDH). In contrast, sserum levels of IL-6, CXCL8 and IFNγ were elevated at baseline in COVID-19 subjects compared to healthy subjects with IL-6 (p=0.002) and CXCL8 (p=0.023) levels being further elevated after antiviral therapy. IL-1β (p=0.002) and TNFα (p=0.023) levels were also enhanced after treatment but baseline levels were similar to those of healthy controls. These changes occurred irrespective of whether patients were admitted to the intensive care unit.

Conclusion

Antiviral treatments did not suppress the inflammatory phase of COVID-19 after 7 days treatment although CT, CRP and LDH suggest a decline in lung inflammation. There was limited evidence for a viral-mediated cytokine storm in these COVID-19 subjects.

中文翻译：

Favipiravir 或 Kaletra 治疗 7 天后 COVID-19 患者血清细胞因子水平

背景

导致 2019 年冠状病毒病 (COVID-19) 的严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 已感染 8640 万患者，并导致全球 186 万人死亡。重症 COVID-19 患者血液中白细胞介素 6 (IL-6)、IL-1β、肿瘤坏死因子 (TNF)α、CXCL8 和干扰素 (IFN)γ 水平升高。

客观的

研究抗病毒治疗血清细胞因子对重症 COVID-19 患者的影响。

方法

从入院时和抗病毒（法匹拉韦或洛匹那韦/利托那韦）治疗 7 天后经实验室确诊的 COVID-19 的 29 名患者（年龄 32-79 岁）采集血液。在这项回顾性观察研究中，患者还接受了标准支持治疗。对胸部计算机断层扫描 (CT) 扫描进行了评估，以调查 COVID-19 的肺部表现。还获得了血清并评估了细胞因子水平。研究了 19 名年龄和性别匹配的健康对照。

结果

抗病毒治疗显着降低了 CT 扫描评分和升高的 C 反应蛋白 (CRP) 和乳酸脱氢酶 (LDH) 血清水平。相比之下，与健康受试者相比，COVID-19 受试者的基线 IL-6、CXCL8 和 IFNγ 水平升高，抗病毒治疗后 IL-6 (p=0.002) 和 CXCL8 (p=0.023) 水平进一步升高。治疗后 IL-1β (p=0.002) 和 TNFα (p=0.023) 水平也有所提高，但基线水平与健康对照组相似。无论患者是否被送入重症监护病房，这些变化都会发生。