Effect of Recombinant Human Granulocyte Colony–Stimulating Factor for Patients With Coronavirus Disease 2019 (COVID-19) and Lymphopenia

作者：Lin-ling Cheng, Wei-Jie Guan, Chong-yang Duan, Nuo-fu Zhang, Chun-liang Lei, Yu Hu, Ai-lan Chen, Shi-yue Li, Chao Zhuo, Xi-long Deng, Fan-jun Cheng, Yong Gao, Jian-heng Zhang, Jiaxing Xie, Hong Peng, Ying-xian Li, Xiao-xiong Wu, Wen Liu, Hui Peng, Jian Wang, Guangming Xiao, Ping-Yan Chen, Chunyan Wang, Zi-feng Yang, Jin-cun Zhao, Nanshan Zhong · 发表于：JAMA Internal Medicine · 年份：2020 · DOI：10.1001/jamainternmed.2020.5503 · 被引用次数：82 · 研究领域：COVID-19 Clinical Research Studies、Long-Term Effects of COVID-19、SARS-CoV-2 and COVID-19 Research

Importance: Lymphopenia is common and correlates with poor clinical outcomes in patients with coronavirus disease 2019 (COVID-19). Objective: To determine whether a therapy that increases peripheral blood leukocyte and lymphocyte cell counts leads to clinical improvement in patients with COVID-19. Design, Setting and Participants: Between February 18 and April 10, 2020, we conducted an open-label, multicenter, randomized clinical trial at 3 participating centers in China. The main eligibility criteria were pneumonia, a blood lymphocyte cell count of 800 per μL (to convert to ×109/L, multiply by 0.001) or lower, and no comorbidities. Severe acute respiratory syndrome coronavirus 2 infection was confirmed with reverse-transcription polymerase chain reaction testing. Exposures: Usual care alone, or usual care plus 3 doses of recombinant human granulocyte colony-stimulating factor (rhG-CSF, 5 μg/kg, subcutaneously at days 0-2). Main Outcomes and Measures: The primary end point was the time from randomization to improvement of at least 1 point on a 7-category disease severity score. Results: Of 200 participants, 112 (56%) were men and the median (interquartile range [IQR]) age was 45 (40-55) years. There was random assignment of 100 patients (50%) to the rhG-CSF group and 100 (50%) to the usual care group. Time to clinical improvement was similar between groups (rhG-CSF group median of 12 days (IQR, 10-16 days) vs usual care group median of 13 days (IQR, 11-17 days); hazard ratio,...