European Journal of Molecular & Clinical Medicine

Abstract

Background. Immune-mediated lung injury and complex changes of the immune system, such as lymphopenia and cytokine storm, that have been associated with adverse outcomes underlining a fundamental role of host response in severe acute respiratory syndrome coronavirus 2 infection and the pathogenesis of the disease.
Thymosin alpha 1 (Tα1) is one of the molecules used in the management of COVID-19, because it is known to restore the homeostasis of the immune system during infections and cancer.
AimIn this study we aim to observe the role of thymosin alpha 1 in moderate to severe COVID-19 disease.
Methodology:A retrospective, single-centred study including 244 patients with laboratory-detected moderate to severe SARS-CoV-2 infection admitted to designated COVID-19 centre in a tertiary care hospital from March to October, 2020 was done. 100 patients received thymosin alpha 1 and their results were compared with 144 patients who received standard care without thymosin alpha. Clinical records, laboratory data, and radiological findings were analysed of patients treated with thymosin alpha 1 to evaluate the role oftreament outcome.
Results. 94% (n=94) patients in the thymosin group required oxygen at more than 6 L per minute as compare  to 97.2% (n= 140) of the patients in the non- thymosin group. 35% of patients in the thymosin group (n=35 ) required high flow nasal oxygenation as compare to  49% (n=77) in the non thymosin group. 6% (n= 6)of the patients in the  thymosin group required mechanical ventilation as compare to 11.6% (n=16) in the non  thymosin group with the p-value of 0.17. Then hospital mortality was 6% (n= 6 ) in the  thymosin group as compared to 9.02% (n=13) in the non thymosin group. The median hospital stay was 10 days in the thymosin group as compared to 8 days in the non thymosin group with the p-value of 0.001. 76 patients in the thymosin group had increased CRP levels on day 1 as compared to 119 in the non-thymosin group. On day 5, 21 patients in thymosin group had increased levels as compared to 89 patiemts in the non thymosin group with a significant p-value of < 0.001. Statistically significant results were obtained on day 10, only 13 patients in the thymosingroup had increased levels as compare to 57 in the non thymosin group. On day 1, 89 patients in the thymosin group had increased level of IL-6 as compare to 102 in the non thymosin group. Serial monitoring on day 5 showed that in thymosin group, 35 patient had increased levels as compare to 85 patients in the non thymosin group (with a significant value of <0.05). Again on day 10, the difference was a statistically significant when only 10 patients in the thymosin group had elevated levels as compare to 43 in the non thymosin group.
Conclusion.
Significant difference was seen in terms of biochemical parameters but that could not be translated to clinical improvement measured in terms of need for non invasive/invasive  mechanical ventilation and in hospital mortality rates.