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Efficacy of Thymosin Alpha 1 in the Treatment of COVID-19: A Multicenter Cohort Study #MMPMID34408744
Liu J; Shen Y; Wen Z; Xu Q; Wu Z; Feng H; Li Z; Dong X; Huang S; Guo J; Zhang L; Chen Y; Li W; Zhu W; Du H; Liu Y; Wang T; Chen L; Teboul JL; Annane D; Chen D
Front Immunol 2021[]; 12 (?): 673693 PMID34408744show ga
BACKGROUND: Thymosin alpha 1 (Talpha1) is widely used to treat patients with COVID-19 in China; however, its efficacy remains unclear. This study aimed to explore the efficacy of Talpha1 as a COVID-19 therapy. METHODS: We performed a multicenter cohort study in five tertiary hospitals in the Hubei province of China between December 2019 and March 2020. The patient non-recovery rate was used as the primary outcome. RESULTS: All crude outcomes, including non-recovery rate (65/306 vs. 290/1,976, p = 0.003), in-hospital mortality rate (62/306 vs. 271/1,976, p = 0.003), intubation rate (31/306 vs. 106/1,976, p = 0.001), acute respiratory distress syndrome (ARDS) incidence (104/306 vs. 499/1,976, p = 0.001), acute kidney injury (AKI) incidence (26/306 vs. 66/1,976, p < 0.001), and length of intensive care unit (ICU) stay (14.9 +/- 12.7 vs. 8.7 +/- 8.2 days, p < 0.001), were significantly higher in the Talpha1 treatment group. After adjusting for confounding factors, Talpha1 use was found to be significantly associated with a higher non-recovery rate than non-Talpha1 use (OR 1.5, 95% CI 1.1-2.1, p = 0.028). An increased risk of non-recovery rate associated with Talpha1 use was observed in the patient subgroups with maximum sequential organ failure assessment (SOFA) scores >/=2 (OR 2.0, 95%CI 1.4-2.9, p = 0.024), a record of ICU admission (OR 5.4, 95%CI 2.1-14.0, p < 0.001), and lower PaO2/FiO2 values (OR 1.9, 95%CI 1.1-3.4, p = 0.046). Furthermore, later initiation of Talpha1 use was associated with a higher non-recovery rate. CONCLUSION: Talpha1 use in COVID-19 patients was associated with an increased non-recovery rate, especially in those with greater disease severity.
|*COVID-19 Drug Treatment[MESH]
|Adult[MESH]
|Aged[MESH]
|COVID-19/complications/diagnosis/mortality[MESH]
|Female[MESH]
|Hospital Mortality[MESH]
|Humans[MESH]
|Intensive Care Units/statistics & numerical data[MESH]
free
free
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Front+Immunol 2021 ; 12 (?): 673693
