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Interferon gamma immunotherapy in five critically ill COVID-19 patients with impaired cellular immunity: A case series.

Med (New York, N.Y.)

Authors: Arjan van Laarhoven, Lisa Kurver, Gijs J Overheul, Emma J Kooistra, Wilson F Abdo, Reinout van Crevel, Raphaël Duivenvoorden, Matthijs Kox, Jaap Ten Oever, Jeroen Schouten, Frank L van de Veerdonk, Hans van der Hoeven, Janette Rahamat-Langendoen, Ronald P van Rij, Peter Pickkers, Mihai G Netea

BACKGROUND: Prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding has been described in immunocompromised coronavirus disease 2019 (COVID-19) patients, resulting in protracted disease and poor outcome. Specific therapy to improve viral clearance and outcome for this group of patients is currently unavailable.

METHODS: Five critically ill COVID-19 patients with severe defects in cellular immune responses, high SARS-CoV-2 viral RNA loads, and no respiratory improvement were treated with interferon gamma, 100 μg subcutaneously, thrice weekly. Bronchial secretion was collected every 48 h for routine diagnostic SARS-CoV-2 RT-PCR and viral culture.

FINDINGS: Interferon gamma administration was followed by a rapid decline in SARS-CoV-2 load and a positive-to-negative viral culture conversion. Four patients recovered, and no signs of hyperinflammation were observed.

CONCLUSIONS: Interferon gamma may be considered as adjuvant immunotherapy in a subset of immunocompromised COVID-19 patients.

FUNDING: A.v.L. and R.v.C. are supported by National Institutes of Health (R01AI145781). G.J.O. and R.P.v.R. are supported by a VICI grant (016.VICI.170.090) from the Dutch Research Council (NWO). W.F.A. is supported by a clinical fellowship grant (9071561) of Netherlands Organization for Health Research and Development. M.G.N. is supported by an ERC advanced grant (833247) and a Spinoza grant of the Netherlands Organization for Scientific Research.

© 2021 Elsevier Inc.

PMID: 34568856

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