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Efficacy of Thymosin Alpha 1 in the Treatment of COVID-19: A Multicenter Cohort Study.
Liu, Jiao; Shen, Yanfei; Wen, Zhenliang; Xu, Qianghong; Wu, Zhixiong; Feng, Huibin; Li, Zhongyi; Dong, Xuan; Huang, Sisi; Guo, Jun; Zhang, Lidi; Chen, Yizhu; Li, Wenzhe; Zhu, Wei; Du, Hangxiang; Liu, Yongan; Wang, Tao; Chen, Limin; Teboul, Jean-Louis; Annane, Djillali; Chen, Dechang.
  • Liu J; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Shen Y; Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou, China.
  • Wen Z; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Xu Q; Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou, China.
  • Wu Z; Department of Surgical Intensive Care Unit, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
  • Feng H; Intensive Care Unit, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China.
  • Li Z; Department of Critical Care Medicine, Wuhan No.9 Hospital, Wuhan, China.
  • Dong X; Tuberculosis and Respiratory Department, Wuhan Jinyintan Hospital, Wuhan, China.
  • Huang S; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Guo J; Intensive Care Unit, Huazhong University of Science and Technology Union Jiangbei Hospital, Wuhan, China.
  • Zhang L; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Chen Y; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Li W; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Zhu W; Intensive Care Unit, Tianyou Hospital Affiliated to Wuhan University of Science & Technology, Wuhan, China.
  • Du H; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Liu Y; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Wang T; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Chen L; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Teboul JL; Service de Médecine-Intensive Réanimation, Hôpital Bicêtre, AP-HP. Université Paris-Saclay, Inserm UMR 999, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
  • Annane D; Department of Intensive Care, Hôpital Raymond Poincaré (APHP), Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, University Versailles Saint Quentin - University Paris Saclay, INSERM, Garches, France.
  • Chen D; Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Immunol ; 12: 673693, 2021.
Article in English | MEDLINE | ID: covidwho-1365541
ABSTRACT

Background:

Thymosin alpha 1 (Tα1) is widely used to treat patients with COVID-19 in China; however, its efficacy remains unclear. This study aimed to explore the efficacy of Tα1 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 Tα1 treatment group. After adjusting for confounding factors, Tα1 use was found to be significantly associated with a higher non-recovery rate than non-Tα1 use (OR 1.5, 95% CI 1.1-2.1, p = 0.028). An increased risk of non-recovery rate associated with Tα1 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 Tα1 use was associated with a higher non-recovery rate.

Conclusion:

Tα1 use in COVID-19 patients was associated with an increased non-recovery rate, especially in those with greater disease severity.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Thymalfasin / COVID-19 Drug Treatment Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Front Immunol Year: 2021 Document Type: Article Affiliation country: Fimmu.2021.673693

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Thymalfasin / COVID-19 Drug Treatment Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Front Immunol Year: 2021 Document Type: Article Affiliation country: Fimmu.2021.673693