LB1533. Impact of Treatment of Hospitalised COVID-19 Patients With Inhaled Interferon Beta-1a (SNG001) on Long COVID Symptoms: Results From the SPRINTER trial

Monk, Phillip; Evans, Rachael A.; Tear, Victoria; Brookes, Jody; Batten, Toby; Mańkowski, M; Djukanović, Ratko; Holgate, Stephen T.; Brightling, Chris; Wilkinson, Tom

doi:10.1093/ofid/ofac492.1879

Cited by 3 publications

(1 citation statement)

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“…The anti-viral remdesivir is associated with a reduction in rates of Long Covid at 180 days, although the study excluded severely unwell patients so this benefit may not apply to a broader population [30]. Post-hoc analysis of nebulised interferon-beta-1a for COVID-19 showed reductions in fatigue/malaise and loss of taste or smell at 60-90 days compared to placebo, and further investigation is ongoing [31]. Metformin reduces the risk of Long Covid in non-hospitalised overweight and obese patients, although the effect in more severe disease is unknown [32].…”

Section: Discussionmentioning

confidence: 99%

One year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study

Leavy,

Russell,

Harrison

et al. 2023

Preprint

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BackgroundIn patients with COVID-19 requiring supplemental oxygen, dexamethasone reduces acute severity and improves survival, but longer-term effects are unknown. We hypothesised that systemic corticosteroid administration during acute COVID-19 would be associated with improved health-related quality of life (HRQoL) one year after discharge.MethodsAdults admitted to hospital between February 2020 and March 2021 for COVID-19 and meeting current guideline recommendations for dexamethasone treatment were included using two prospective UK cohort studies. HRQoL, assessed by EQ-5D-5L utility index, pre-hospital and one year after discharge were compared between those receiving corticosteroids or not after propensity weighting for treatment. Secondary outcomes included patient reported recovery, physical and mental health status, and measures of organ impairment. Sensitivity analyses were undertaken to account for survival and selection bias.FindingsIn 1,888 participants included in the primary analysis, 1,149 received corticosteroids. There was no between-group difference in EQ-5D-5L utility index at one year (mean difference 0.004, 95% CI: -0.026 to 0.034,p= 0.77). A similar reduction in EQ-5D-5L was seen at one year between corticosteroid exposed and non-exposed groups (mean (SD) change -0.12 (0.22) vs -0.11 (0.22),p= 0.32). Overall, there were no differences in secondary outcome measures. After sensitivity analyses modelled using a larger cohort of 109,318 patients admitted to hospital with COVID-19, EQ-5D-5L utility index at one year remained similar between the two groups.InterpretationSystemic corticosteroids for acute COVID-19 have no impact on the large reduction in HRQoL one year after hospital discharge. Treatments to address this are urgently needed.Take home messageSystemic corticosteroids given for acute COVID-19 do not affect health-related quality of life or other patient reported outcomes, physical and mental health outcomes, and organ function one year after hospital discharge

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Section: Discussionmentioning

confidence: 99%

One year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study

Leavy,

Russell,

Harrison

et al. 2023

Preprint

Self Cite

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Protective effect of interferon type I on barrier function of human airway epithelium during rhinovirus infections in vitro

Boland,

Endres,

Kinscherf

et al. 2024

Sci Rep

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The airway epithelium provides a crucial barrier against infection with respiratory pathogens. This barrier can be impaired following viral infection, paving the way for bacterial superinfections. Type I interferons (IFNs) are important antiviral mediators, and inhaled formulations of these glycoproteins are considered a potential approach for the treatment of respiratory viral infections. To investigate if type I IFNs can also protect against virus-induced epithelial barrier dysfunction, differentiated primary bronchial epithelial cells were pre-treated with IFN-β1a and subsequently infected with human rhinovirus (HRV) for 24 to 72h. Moreover, to functionally assess the effects of IFN-β1a pre-treatment on barrier integrity, we conducted co-infection experiments, in which cells were initially infected with HRV, and superinfected with Streptococcus pneumoniae 24 to 72 h later. In untreated cells, HRV infection significantly damaged ZO-1 positive tight junctions and cilia, and transiently increased permeability, whereas the barrier of cultures pre-treated with IFN-β1a remained intact. In co-infection experiments, bacteria were able to penetrate deeper into the cell layers of HRV-infected cultures than into those of uninfected cells. IFN-β1a pre-treatment abrogated virus-induced damage to the epithelial barrier. Taken together, these data demonstrate a beneficial effect of IFN-β in protecting epithelial barrier function in addition to its antiviral effects.

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1-year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study

Leavy,

Russell,

Harrison

et al. 2024

ERJ Open Res

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Background.In patients with COVID-19 requiring supplemental oxygen, dexamethasone reduces acute severity and improves survival, but longer-term effects are unknown. We hypothesised that systemic corticosteroid administration during acute COVID-19 would be associated with improved health-related quality of life (HRQoL) one year after discharge.Methods.Adults admitted to hospital between February 2020 and March 2021 for COVID-19 and meeting current guideline recommendations for dexamethasone treatment were included using two prospective UK cohort studies (PHOSP-COVID and ISARIC (UK)). HRQoL, assessed by EQ-5D-5L utility index (UI), pre-hospital and one year after discharge were compared between those receiving corticosteroids or not after propensity weighting for treatment. Secondary outcomes included patient reported recovery, physical and mental health status, and measures of organ impairment. Sensitivity analyses were undertaken to account for survival and selection bias.Findings.In 1888 participants included in the primary analysis, 1149 received corticosteroids. There was no between-group difference in EQ-5D-5L UI at one year (mean difference 0.004, 95% CI: −0.026 to 0.034). A similar reduction in EQ-5D-5L was seen at one year between corticosteroid exposed and non-exposed groups (mean (sd) change −0.12 (0.22)versus−0.11 (0.22)). Overall, there were no differences in secondary outcome measures. After sensitivity analyses modelled using a cohort of 109 318 patients admitted to hospital with COVID-19, EQ-5D-5L UI at one year remained similar between the two groups.Interpretation.Systemic corticosteroids for acute COVID-19 have no impact on the large reduction in HRQoL one year after hospital discharge. Treatments to address the persistent reduction in HRQoL are urgently needed.

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LB1533. Impact of Treatment of Hospitalised COVID-19 Patients With Inhaled Interferon Beta-1a (SNG001) on Long COVID Symptoms: Results From the SPRINTER trial

Cited by 3 publications

References 0 publications

One year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study

One year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study

Protective effect of interferon type I on barrier function of human airway epithelium during rhinovirus infections in vitro

1-year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study

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