Immune-based therapeutic approaches in COVID-19

Moeinafshar, Aysan; Yazdanpanah, Niloufar; Rezaei, Nima

doi:10.1016/j.biopha.2022.113107

Cited by 4 publications

(4 citation statements)

References 157 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both repurposed existing medicines and novel therapeutics require formal scrutiny prior to widespread use in the affected population. Hence, at the design of our study, no clear consensus has emerged regarding the best pharmacotherapeutic options in patients with mild to moderate Long COVID [16][17][18].…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Reducing sick leave, improving work ability, and quality of life in patients with mild to moderate Long COVID through psychosocial, physiotherapeutic, and nutritive supportive digital intervention (MiLoCoDaS): study protocol for a randomized controlled trial

Krotz,

Sosnowsky-Waschek,

Bechtel

et al. 2023

Trials

View full text Add to dashboard Cite

Background Following SARS-CoV-2 infection, a relevant proportion of patients suffer from persistent or recurring sequela, even after initially mild primary illness. Many patients experience exhaustion and fatigue, rendering them incapable of working. Long COVID exerts a substantial burden on society and the healthcare system: at least 65 million people are currently affected worldwide. The underlying pathobiology is a complex derangement in several organ systems. To date, causal pharmaceutical therapies remain elusive. Waiting lists for specialist care are long. Rapidly scalable digital interventions offering support for the frequent subgroup of patients with mild to moderate impairment from Long COVID are urgently needed. The MiLoCoDaS study compares three intensities of a potentially rapidly scalable digital intervention aiming to accelerate recovery. The overall objective is to figure out if there is a difference in the effect sizes between these modalities. Methods The online intervention uses a learning platform (LMS, TYPO3 framework) comprising 12 sessions of medical, psychological, physiotherapeutic, and nutritional content. The three modalities differ as follows: patient information only (sham intervention, control), information plus interactive digital workbook including practical exercises (digital intervention), and the digital workbook augmented by once-weekly online seminars and discussion groups (person and peer-contact). Eligible patients are 18–67 years old satisfying Long COVID diagnostic criteria. Patients are recruited through primary care physicians and randomly allocated. The primary endpoint is the number of sick leave days during the 6-month observation period; secondary endpoints are patient-reported symptoms, quality of life, and work ability. The study size provides a power of 80% at a type I error of < 0.05 to show an effect size of Cohen = 0.3 between the augmented and the sham intervention (N = 152 per arm, total accounting for attrition N = 600). Discussion If one of the two interventions is superior to providing information alone, MiLoCoDaS would provide the starting point for a rapidly scalable digital intervention for the frequent and currently underserved patient group with mild to moderate impairment from Long COVID. Several caveats pertain to the heterogeneity of Long COVID manifestation and duration prior to inclusion. It is conceivable that the possible effect of the intervention may differ across subgroups. Therefore, a priori defined secondary analysis will be conducted. Trial registration German Clinical Trials Register (DRKS) DRKS00028964. Registered on 24 August 2022.

show abstract

Section: Background and Rationale {6a}mentioning

confidence: 99%

Reducing sick leave, improving work ability, and quality of life in patients with mild to moderate Long COVID through psychosocial, physiotherapeutic, and nutritive supportive digital intervention (MiLoCoDaS): study protocol for a randomized controlled trial

Krotz,

Sosnowsky-Waschek,

Bechtel

et al. 2023

Trials

View full text Add to dashboard Cite

show abstract

“…Forty-two patients in the IFN arm had lower 28-day overall mortality compared with thirty-nine patients in the control arm. Type-I IFN can over-activate the inflammatory response; less toxic IFN III can be used instead of IFN I, with a similar antiviral effect [ 152 ]. Pegylated (PEG) IFN-λ1a was investigated in patients with mild-to-moderate COVID-19 [ 153 ].…”

Section: Immunomodulatory Treatment Of Moderate-to-severe Covid-19—di...mentioning

confidence: 99%

From Cytokine Storm to Cytokine Breeze: Did Lessons Learned from Immunopathogenesis Improve Immunomodulatory Treatment of Moderate-to-Severe COVID-19?

et al. 2022

View full text Add to dashboard Cite

Complex immune response to infection has been highlighted, more than ever, during the COVID-19 pandemic. This review explores the immunomodulatory treatment of moderate-to-severe forms of this viral sepsis in the context of specific immunopathogenesis. Our objective is to analyze in detail the existing strategies for the use of immunomodulators in COVID-19. Immunomodulating therapy is very challenging; there are still underpowered or, in other ways, insufficient studies with inconclusive or conflicting results regarding a rationale for adding a second immunomodulatory drug to dexamethasone. Bearing in mind that a “cytokine storm” is not present in the majority of COVID-19 patients, it is to be expected that the path to the adequate choice of a second immunomodulatory drug is paved with uncertainty. Anakinra, a recombinant human IL-1 receptor antagonist, is a good choice in this setting. Yet, the latest update of the COVID-19 Treatment Guidelines Panel (31 May 2022) claims that there is insufficient evidence to recommend either for or against the use of anakinra for the treatment of COVID-19. EMA’s human medicines committee recommended extending the indication of anakinra to include treatment of COVID-19 in adult patients only recently (17 December 2021). It is obvious that this is still a work in progress, with few ongoing clinical trials. With over 6 million deaths from COVID-19, this is the right time to speed up this process. Our conclusion is that, during the course of COVID-19, the immune response is changing from the early phase to the late phase in individual patients, so immunomodulating therapy should be guided by individual responses at different time points.

show abstract

“…According to a survey from the Center for Systems Science and Engineering at Johns Hopkins University, as of 3 March 2023, there were over 676 million confirmed cases of COVID-19 worldwide, including over 6.88 million fatalities (CSSE, 2023). Several treatments have been investigated during the pandemic, including antiviral drugs, anti-inflammatory drugs, cellular therapy, plasma therapy, monoclonal antibodies, and intravenous immunoglobulin therapy (Moeinafshar et al, 2022;Niknam et al, 2022;Lin et al, 2023;Yang et al, 2023). However, some of them were revealed to have no therapeutic effect on COVID-19 (Abdool Karim and Devnarain, 2022;Marcec et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Mendelian randomization analysis identified tumor necrosis factor as being associated with severe COVID-19

et al. 2023

View full text Add to dashboard Cite

Background: Observational studies have shown that anti-tumor necrosis factor (TNF) therapy may be beneficial for patients with coronavirus disease 2019 (COVID-19). Nevertheless, because of the methodological restrictions of traditional observational studies, it is a challenge to make causal inferences. This study involved a two-sample Mendelian randomization analysis to investigate the causal link between nine TNFs and COVID-19 severity using publicly released genome-wide association study summary statistics.Methods: Summary statistics for nine TNFs (21,758 cases) were obtained from a large-scale genome-wide association study. Correlation data between single-nucleotide polymorphisms and severe COVID-19 (18,152 cases vs. 1,145,546 controls) were collected from the COVID-19 host genetics initiative. The causal estimate was calculated by inverse variance-weighted (IVW), MR–Egger, and weighted median methods. Sensitivity tests were conducted to assess the validity of the causal relationship.Results: Genetically predicted TNF receptor superfamily member 6 (FAS) positively correlated with the severity of COVID-19 (IVW, odds ratio = 1.10, 95% confidence interval = 1.01–1.19, p = 0.026), whereas TNF receptor superfamily member 5 (CD40) was protective against severe COVID-19 (IVW, odds ratio = 0.92, 95% confidence interval = 0.87–0.97, p = 0.002).Conclusion: Genetic evidence from this study supports that the increased expression of FAS is associated with the risk of severe COVID-19 and that CD40 may have a potential protective effect against COVID-19.

show abstract

Immune-based therapeutic approaches in COVID-19

Cited by 4 publications

References 157 publications

Reducing sick leave, improving work ability, and quality of life in patients with mild to moderate Long COVID through psychosocial, physiotherapeutic, and nutritive supportive digital intervention (MiLoCoDaS): study protocol for a randomized controlled trial

Reducing sick leave, improving work ability, and quality of life in patients with mild to moderate Long COVID through psychosocial, physiotherapeutic, and nutritive supportive digital intervention (MiLoCoDaS): study protocol for a randomized controlled trial

From Cytokine Storm to Cytokine Breeze: Did Lessons Learned from Immunopathogenesis Improve Immunomodulatory Treatment of Moderate-to-Severe COVID-19?

Mendelian randomization analysis identified tumor necrosis factor as being associated with severe COVID-19

Contact Info

Product

Resources

About