期刊
SIGNAL TRANSDUCTION AND TARGETED THERAPY
卷 6, 期 1, 页码 -出版社
SPRINGERNATURE
DOI: 10.1038/s41392-021-00496-5
关键词
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资金
- US Department of Veterans Affairs [5I01BX001353]
- National Natural Science Foundation of China [31501116]
- Shenzhen Sanming Project of Medicine [SZSM201911013]
- Shenzhen Science and Technology Innovation Commission [JCYJ20190809100005672]
This study found that early interferon therapy in patients with COVID-19 who were also receiving glucocorticoids was associated with earlier hospital discharge, symptom relief, and lower prevalence of prolonged viral shedding. These associations were more significant in glucocorticoid users, indicating a potential therapeutic synergy between interferons and glucocorticoids in COVID-19.
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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