Abstract
BackgroundThe global pandemic of coronavirus disease 2019 (COVID-19) infection is ongoing and associated with high mortality. The aim of this study was to investigate the efficacy and safety of subcutaneous injection of interferon alpha-2b (IFN alpha-2b) combined with lopinavir/ritonavir (LPV/r) in the treatment of COVID-19 infection, compared with that of using LPV/r alone.MethodsPatients diagnosed with laboratory-confirmed COVID-19 infection in Wuhan Red Cross hospital during the period from January 23, 2020 to March 19, 2020 were included. The length of stay, the time to viral clearance and adverse reactions during hospitalization were compared between patients using oral LPV/r and combined therapy of LPV/r and subcutaneous injection of IFN alpha-2b.ResultsA total of 22 patients were treated with LPV/r alone and 19 with combined therapy with subcutaneous injection of IFN alpha-2b. The average length of hospitalization in the combination group was shorter than that of LPV/r group (16 ± 9.7 vs 23 ± 10.5 days; P = 0.028). Moreover, the days of hospitalization in early intervention group decreased from 25 ± 8.5 days to 10 ± 2.9 days compared with delayed intervention group (P = 0.001). Combined therapy with IFN alpha-2b also significantly reduced the duration of detectable virus in the upper respiratory tract. No patient in each group was transferred to intensive care unit (ICU) or died during the treatment. There was no significant difference in the adverse effect composition between two groups.ConclusionsSubcutaneous injection of IFN alpha-2b combined with LPV/r shortened the length of hospitalization and accelerated viral clearance in COVID-19 patients, which deserves further investigation in clinical practice.
Highlights
The global pandemic of coronavirus disease 2019 (COVID-19) infection is ongoing and associated with high mortality
Nasopharyngeal swabs of upper respiratory tract were collected from all patients by two investigators (Tao Liu and Yanbin Liu), and patients enrolled in this study were diagnosed according to the following criteria based on WHO recommendation: isolation of COVID-19 or at least two positive results by reverse-transcription-polymerasechain-reaction (RT-PCR) assay for COVID-19 or a genetic sequence that matched COVID-19 [5]
Further comparison was conducted between early intervention (11 patients received IFN alpha-2b within 72 h of admission) and delayed intervention (8 patients received IFN alpha-2b after 72 h of admission) with IFN alpha-2b, which indicated that the days of hospitalization in early intervention group decreased from 25 ± 8.5 days to 10 ± 2.9 days compared with delayed intervention group (P = 0.001)
Summary
The global pandemic of coronavirus disease 2019 (COVID-19) infection is ongoing and associated with high mortality. The aim of this study was to investigate the efficacy and safety of subcutaneous injection of interferon alpha-2b (IFN alpha-2b) combined with lopinavir/ritonavir (LPV/r) in the treatment of COVID-19 infection, compared with that of using LPV/r alone. Type I interferons have broad spectrum antiviral activities against RNA viruses. They are approved to treat hepatitis B and C but it is reported to inhibit SARSCoV reproduction in vitro [2]. Wang et al BMC Infectious Diseases (2020) 20:723 ribavirin, vapor inhalation of IFN alpha may be considered. The method for administration of IFN alpha is vapor inhalation at a dose of 5 million U (and 2 mL of sterile water for injection) for adults, 2 times/day [3, 4]. Whether vapor inhalation of the medication has a systemic therapeutic effect for treating COVID-19 remains unclear
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