Experience of immunomodulators use for prevention of COVID-19 infection among health care personnel and avoidance of COVID-induced pneumonia complications in patients with СОVID-19


DOI: https://dx.doi.org/10.18565/therapy.2020.7.156-164

Svistunov A.A., Khorobrykh T.V., Makhnach G.K., Krylov A.Yu., Bunina D.V., Volgin M.V., Mishchenko N.P., Agadzhanov V.G., Gandybina E.G.

I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)
Purpose: this paper evaluates the role of immunomodulators use to prevent health personnel COVID-19 infection and to avoid COVID-related pneumonia complications in patients.
Material and methods. 32 health care professionals from COVID hospital I.M. Sechenov First Moscow State Medical University (Sechenov University), who have been constantly working in the «red zone» for three months are enrolled in the clinical study. During the first week of work, the recommended prevention regimen was applied, which was discontinued due to severe side effects.
Moreover, 41 COVID-19 patients with negative dynamics on CT scans and clinical symptoms of a progressive respiratory insufficiency were included in the study.
The new prevention regimen for health staff and the complex treatment regimen for COVID-19 patients included immunomodulator Galavit, interferon donator Kipferon, and inhalable form of virocidal drug aprotinin (Gordox).
Results. By the end of the study IgG were found in 4 health workers, 2 of them had only light COVID symptoms. Another 2 workers did not have any symptoms. There were no side effects. Other 28 of 32 workers did not have any clinical or laboratory signs of SARS-CoV-2 infection.
The addition of immunomodulatory drugs to the standardized treatment regimen in COVID-19 patients contributed to hyperthermia reduction by day 2-3 in 10 (45,5%) patients, increase in SpO2 from 82%±2 to 95% by day 3 in 2 (9,1%) and from 92%±2 to 95% ±2 in 9 (40,9%) patients. Lung parenchyma damage stabilized at a moderate level in 22 (53,7%) patients. A developing pneumonia signs were determined in 18 (43,9%) patients, which allowed to avoid ventilator use and prevent excessive pulmonary fibrosis progression.
Conclusion. The use of virucidal and immunomodulatory drugs contributes to achieve a significant positive clinical effect.
Keywords: COVID-19, medical prevention, SARS-CoV-2, Galavit (aminodihydrophthalazindione sodium), immunomodulators, Kipferon, aprotinin (Gordox)
Read entire article

Literature


  1. Tay M.Z., Poh C.M., Renia L. et al. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020; 20(6): 363–74. doi: 10.1038/s41577-020-0311-8.

  2. Blanco-Melo D., Nilsson-Payant B.E., Liu W.-C. et al. Imbalanced host response to SARS-CoV-2 drives development of COVID-19. Cell. 2020; 181(5): 1036–45.e9. doi: 10.1016/j.cell.2020.04.026.

  3. Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции» (COVID-19). Версия 4 (27.03.2020). Доступ: https://static3.rosminzdrav.ru/system/attachments/attaches/000/049/877/original/COVID19_recomend_v4.pdf (дата обращения – 17.07.2020). [Temporary guidelines «Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)». Version 4 (27.03.2020). URL: https://static3.rosminzdrav.ru/system/attachments/attaches/000/049/877/original/COVID19_recomend_v4.pdf (date of access – 17.07.2020) (In Russ.)].

  4. Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)». Версия 6 (28.04.2020). https://static-1.rosminzdrav.ru/system/attachments/attaches/000/050/122/original/28042020_МR_COVID-19_v6.pdf (дата обращения – 17.07.2020) [Temporary guidelines «Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)». Version 6 (28.04.2020). https://static-1.rosminzdrav.ru/system/attachments/attaches/000/050/122/original/28042020_МR_COVID-19_v6.pdf (date of access – 17.07.2020) (In Russ.)].

  5. Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)». Версия 7 (03.06.2020) https://static-0.rosminzdrav.ru/system/attachments/attaches/000/050/584/original/03062020_МR_COVID-19_v7.pdf (дата обращения – 17.07.2020) [Temporary guidelines «Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)». Version 7 (03.06.2020). https://static-0.rosminzdrav.ru/system/attachments/attaches/000/050/584/original/03062020_МR_COVID-19_v7.pdf (date of access – 17.07.2020) (In Russ.)].

  6. Zhirnov O.P., Klenk H.D., Wright P.F. Aprotinin and similar protease inhibitors as drugs against influenza. Antiviral Res. 2011; 92(1): 27–36. doi: 10.1016/j.antiviral.2011.07.014.

  7. Bottcher-Friebertshauser E., Klenk H.D., Garten W. Activation of influenzа viruses by proteases from host cells and bacteria in the human airway epithelium. Pathog Dis. 2013; 69(2): 87–100. doi: 10.1111/2049-632X.12053.

  8. Жирнов О.П., Малышев Н.А. Новое в лечении гриппа и острых респираторных вирусных инфекций апротинином c помощью ручного пропеллентного мини-ингалятора дозированного типа. Лечащий врач. 2014; 1: 57–62. [Zhirnov O.P., Malyshev N.A. A new direction in the treatment of influenza and acute respiratory viral infections with aprotinin using a manual propellant metered-dose mini-inhaler. Lechaschiy vrach. 2014; 1: 57–62 (In Russ.)].

  9. Сологуб Т.В., Осиновец О.Ю. Применение иммуномодулирующего препарата Галавит в комплексной терапии гриппа. Клиницист. 2012; 2: 1–5. [Sologub T.V., Osinovets O.Yu. Using immunomodulating drug Galavit in treatment of influenza. Klinitsist. 2012; 2: 1–5 (In Russ.)].

  10. Латышева Т.В., Сетдикова Н.Х., Манько К.С. Вторичные иммунодефициты. Возможности использования отечественного иммуномодулятора Галавит. Цитокины и воспаление. 2005; 3: 95–99. [Latysheva T.V., Setdikova N.Kh., Manko K.S. Secondary immunodeficiencies. Possibilities of using the domestic immunomodulator Galavit. Tsitokiny i vospaalenie. 2005; 3: 95–99 (In Russ.)].

  11. Корсунский В.Н., Брускин А.Б., Денисов Л.А., Иванов Р.А. Сравнительное изучение фармакокинетики различных лекарственных форм интерферона альфа-2b. Эффективная фармакотерапия в акушерстве и гинекологии. 2007; 1: 24–29. [Korsunsky V.N., Bruskin A.B., Denisov L.A., Ivanov R.A. Comparative study of the pharmacokinetics of various dosage forms of interferon alpha-2b. Effektivnaya farmakoterapiya v akusherstve i ginekologii. 2007; 1: 24–29 (In Russ.)].

  12. Приказ Минздрава России от 19.03.2020 № 198н «О временном порядке организации работы медицинских организаций в целях реализации мер по профилактике и снижению рисков распространения новой коронавирусной инфекции COVID-19». В ред. приказа Минздрава России от 27.03.2020 № 246н, от 02.04.2020 № 264н, от 29.04.2020 № 385н, от 18.05.2020 № 459н. Доступ: https://minjust.consultant.ru/documents/45802 (дата обращения – 17.07.2020). [Order of the Ministry of Healthcare of Russia dated 03.19.2020 No. 198n «On the temporary procedure for organizing the work of medical organizations in order to implement measures to prevent and reduce the risks of the spread of a new coronavirus infection COVID 19)». As amended by the order of the Ministry of Healthcare of Russia dated 27.03.2020 No. 246n, dated 02.04.2020 No. 264n, dated 29.04.2020 No. 385n, dated 18.05.2020 No. 459n). URL: https://minjust.consultant.ru/documents/45802 (date of access – 17.07.2020) (In Russ.)].

  13. Письмо Роспотребнадзора от 09.04.2020 № 02/6509 2020 32 «О рекомендациях по предупреждению распространения новой коронавирусной инфекции в медицинских организациях». Доступ: https://www.rospotrebnadzor.ru/region/korono_virus/rek_ros.php (дата обращения – 17.07.2020). [Letter of Rospotrebnadzor dated 09.04.2020 No. 02/6509 2020 32 «On recommendations for preventing the spread of a new coronavirus infection in medical organizations» (date of access – 17.07.2020) (In Russ.)].

  14. Свистунов А.А., Махнач Г.К., Бунина Д.В. с соавт. Применение иммуномодулирующего препарата аминодигидрофталазиндиона натрия для предотвращения прогрессирования пневмонии COVID-19. Терапевтический архив. 2020; 11: 3–10. [Svistunov A.A., Makhnach G.K., Bunina D.V. et al. Administration of the immunomodulatory drug aminodihydrophthalazinedione sodium for prevention of progression pneumonia induced COVID-19. Terapevtichesky arkhiv. 2020; 11: 3–10 (In Russ.)]. doi: 10.26442/00403660.2020.11.000820.

  15. Wang Y., Wu W., Cheng Z. et al. Super-factors associated with transmission of occupational COVID-19 infection among healthcare staff in Wuhan, China. J Hosp Infect. 2020; 106(1): 25–34. doi: 10.1016/j.jhin.2020.06.023.


About the Autors

Andrey A. Svistunov, MD, professor, corresponding member of RAS, first vice-rector of I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119146, Moscow, 19 Bol`shaya Piogovskaya Str., building 1. E-mail: 6229808@mail.ru. ORCID: 0000-0003-1592-5703
Тatiana V. Khorobryh, MD, professor of RAS, professor, head of the Department of faculty surgery No. 2 of I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119048, Moscow, 15 Dovatora Str. E-mail: horobryh68@list.ru. ORCID: 0000-0001-5769-5091
Gennadiy K. Makhnach, PhD, associate professor of pulmonology of I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119048, Moscow, 15 Dovatora Str., building 2. E-mail: Makhnach.g.k@yandex.ru. ORCID: 0000-0002-4820-3654
Alexey Yu. Krylov, MD, professor of the Department of faculty surgery No. 2 of I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119048, Moscow, 15 Dovatora Str. E-mail: doctorwing@mail.ru. ORCID: 0000-0003-0328-0223
Daria V. Bunina, pulmonologist of I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119146, Moscow, 19 Bol`shaya Piogovskaya Str., building 1. E-mail: Boon-87@mail.ru. ORCID: 0000-0002-5646-765X
Maksim V. Volgin, clinical resident of the Department of faculty surgery No. 2 of I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119048, Moscow, 15 Dovatora Str. E-mail: Maxvolgin_m@mail.ru. ORCID: 0000-0001-6197-6814
Natalia P. Mishchenko, clinical resident of the Department of faculty surgery No. 2 of I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119048, Moscow, 15 Dovatora Str. Tel.: +7 (968) 647-11-44. E-mail: nataschamishchenko@yandex.ru. ORCID: 0000-0002-4205-7748
Vadim G.Agadzhanov, PhD, associate professor of the Department of faculty surgery No. 2 of I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119048, Moscow, 15 Dovatora Str. E-mail: agadjanov@mail.ru. ORCID: 0000-0002-4068-8431
Elena G. Gandybina, PhD, associate professor of the Department of faculty surgery No. 2 of I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119048, Moscow, 15 Dovatora Str. E-mail: alzas2007@rambler.ru. ORCID: 0000-0002-6765-515

Back to Content

Бионика Медиа