Interleukin-7 therapy improves lymphocyte counts in sepsis and COVID-19 patients
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Key Takeaway
RhIL-7 boosts lymphocytes in sepsis and COVID-19 but only cuts secondary infections in COVID-19 patients.
A systematic review and meta-analysis of four studies evaluated recombinant human interleukin-7 (rhIL-7) for infection-associated lymphopenia in sepsis and COVID-19 patients. The primary outcome was absolute lymphocyte counts (ALC), with secondary outcomes including mortality, ICU stay, and secondary infection incidence.
In septic patients, rhIL-7 significantly increased ALC at three and four weeks, with mean differences of 1.33 and 1.14, respectively. CD4 and CD8 T-cell counts also rose significantly. However, rhIL-7 did not reduce mortality or secondary infection rates in sepsis.
For COVID-19 patients, rhIL-7 did not significantly increase ALC at 30 days or reduce mortality. Notably, it significantly reduced the incidence of secondary infections, with a risk ratio of 0.58. Combined analysis confirmed increased ALC and reduced secondary infection risk.
Limitations include potential confounding from the pandemic context. Safety data were not reported. The findings suggest rhIL-7 ameliorates lymphopenia but may not improve overall prognosis, except for reducing infections in COVID-19.
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View Original Abstract ↓
PURPOSE: This study aims to evaluate the efficacy of recombinant human interleukin-7 (rhIL-7) in treating lymphopenia and related clinical outcomes in patients with infection-associated lymphopenia through a meta-analysis.
METHODS: A Literature retrieval was conducted across databases, including the Cochrane Library, Web of Science, PubMed, Embase, SinoMed, CNKI, Wanfang, and VIP from the inception until October 2025. Randomized controlled trials of rhIL-7 for the treatment of lymphopenia were screened and identified for eligibility. Primary outcomes included absolute lymphocyte counts (ALC), mortality, intensive care unit (ICU) length of stay, and incidence of secondary infections.
RESULTS: Four studies were included, covering sepsis and COVID-19. In septic patients, rhIL-7 significantly increased ALC (MD = 1.33 at 3 weeks; 95% CI [0.29, 2.38]; MD = 1.14 at 4 weeks; 95% CI [0.02, 2.25]), CD4 T-cell counts (MD = 0.56 at 3 weeks; 95% CI [0.08, 1.05]) and CD8 T-cell counts (MD = 0.40 at 2 weeks; 95% CI [0.05, 0.76]). However, rhIL-7 failed to reduce mortality (RR = 1.01; 95% CI [0.36, 2.81]) or the incidence of secondary infections (RR = 1.05; 95% CI [0.48, 2.30]) in patients with sepsis. In patients with COVID-19, rhIL-7 did not significantly increase ALC at 30 days (MD = 0.46; 95% CI [-0.15, 1.08]) or reduce mortality (RR = 0.85; 95% CI [0.55, 1.33]), but it did significantly reduce the incidence of secondary infections (RR = 0.58; 95% CI [0.46, 0.74]; p < 0.0001). A combined analysis revealed that rhIL-7 significantly increased ALC (MD = 1.15 at 3 weeks; 95% CI [0.47, 1.84]; MD = 0.80 at 4 weeks; 95% CI [0.24, 1.36]) and reduced the risk of secondary infections (RR = 0.64; 95% CI [0.50, 0.81]), but had no effect on mortality or ICU length of stay.
CONCLUSION: RhIL-7 effectively ameliorates sepsis-associated lymphopenia but does not improve prognosis. Although rhIL-7 reduces the incidence of secondary infections in COVID-19 patients, confounding factors related to the pandemic context must be taken into account.
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