已在免疫功能低下的冠状病毒病2019(COVID-19)患者中描述了长期的严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)脱落,导致长期的疾病和不良的结果。目前尚无法获得改善该组患者的病毒清除和结果的特定疗法。
5例细胞免疫反应严重缺陷的重症COVID-19患者,高SARS-CoV-2病毒RNA载量,干扰素γ治疗没有呼吸改善,100μg皮下,每周三次。每48小时收集支气管分泌物,用于常规诊断SARS-CoV-2RT-PCR和病毒培养。
干扰素γ给药之后,SARS-CoV-2载量迅速下降,病毒培养物转化为阳性至阴性。四名患者康复,没有观察到炎症过度的迹象。
干扰素γ可作为免疫功能低下的COVID-19患者亚组的辅助免疫疗法。
A.v.L.和R.v.C.由美国国立卫生研究院(R01AI145781)支持。G.J.O.和R.P.v.R.由VICI资助(016。VICI.170.090)来自荷兰研究委员会(NWO)。W.F.A.由荷兰卫生研究与发展组织的临床研究金赠款(9071561)支持。M.G.N.由ERC高级资助(833247)和荷兰科学研究组织的Spinoza资助。
Prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding has been described in immunocompromised coronavirus disease 2019 (COVID-19) patients, resulting in protracted disease and poor outcome. Specific therapy to improve viral clearance and outcome for this group of patients is currently unavailable.
Five critically ill COVID-19 patients with severe defects in cellular immune responses, high SARS-CoV-2 viral RNA loads, and no respiratory improvement were treated with interferon gamma, 100 μg subcutaneously, thrice weekly. Bronchial secretion was collected every 48 h for routine diagnostic SARS-CoV-2 RT-PCR and viral culture.
Interferon gamma administration was followed by a rapid decline in SARS-CoV-2 load and a positive-to-negative viral culture conversion. Four patients recovered, and no signs of hyperinflammation were observed.
Interferon gamma may be considered as adjuvant immunotherapy in a subset of immunocompromised COVID-19 patients.
A.v.L. and R.v.C. are supported by National Institutes of Health (R01AI145781). G.J.O. and R.P.v.R. are supported by a VICI grant (016.VICI.170.090) from the Dutch Research Council (NWO). W.F.A. is supported by a clinical fellowship grant (9071561) of Netherlands Organization for Health Research and Development. M.G.N. is supported by an ERC advanced grant (833247) and a Spinoza grant of the Netherlands Organization for Scientific Research.