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Interferon-α-2b aerosol inhalation is associated with improved clinical outcomes in patients with coronavirus
Jiong Yu1,2, Xuan Lu1,2, Ling Tong1,3
1State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou City, 310003, China.
Aims:
Type 1 interferon (IFN) is used to treat patients with coronavirus disease-2019 (COVID-19) but robust supporting evidence is lacking. We investigated the association between IFN-α-2b and the clinical outcomes of patients with COVID-19.
Methods:
A total of 1401 patients were enrolled, with 852 (60.8%) patients receiving 5 000 000 U of IFN-α-2b via aerosol inhalation twice daily. The primary outcome was a composite measure consisting of mechanical ventilation, intensive care unit (ICU) admission and death. A subgroup analysis was performed to investigate the impact of the IFN-α-2b initiation schedule on symptom onset.
Results:
The risk probability for crude endpoints was lower in the IFN-α-2b group (3.8%) than in the non-IFN-α-2b group (9.3%, P < .001). After adjusting the confounding factors, IFN-α-2b therapy achieved a reduction of 64% in occurrence of endpoint events (hazard ratio, 0.36; 95% confidence interval [CI], 0.21-0.62). In the subgroup analysis, compared with patients who received IFN-α-2b treatment 0-2 days after symptom onset, the hazard ratio for endpoints was 2.2 (95% CI, 0.43-11.13) in patients who received the therapy 3-5 days after symptom onset, 5.89 (95% CI, 0.99-35.05) in patients who received the therapy 6-8 days after symptom onset, and remained at a high level thereafter.
Conclusions:
IFN-α-2b aerosol inhalation therapy may be associated with improved clinical outcomes in patients with COVID-19, and delayed IFN-α-2b intervention was associated with increased probabilities of risk events. Further randomized clinical trials are needed to validate the preliminary findings of this study.
Insights
Type 1 interferon-alpha 2b (IFN-α-2b) aerosol inhalation may improve COVID-19 outcomes. Early treatment (0-2 days) showed better results, while delayed intervention increased risks. Further trials are needed.
Area of Science:
- Infectious Diseases
- Immunology
- Pulmonology
Background:
- Type 1 interferon (IFN) is utilized in treating coronavirus disease-2019 (COVID-19), but evidence remains limited.
- Investigating the efficacy of IFN-α-2b in COVID-19 patients is crucial.
Purpose of the Study:
- To assess the association between IFN-α-2b aerosol inhalation and clinical outcomes in COVID-19 patients.
- To evaluate the impact of the IFN-α-2b treatment initiation schedule on symptom onset.
Main Methods:
- A cohort of 1401 COVID-19 patients was analyzed.
- 852 patients received IFN-α-2b via aerosol inhalation twice daily.
- Primary outcome: composite of mechanical ventilation, ICU admission, or death. Subgroup analysis on treatment timing.
Main Results:
- The IFN-α-2b group had significantly lower crude endpoint risk (3.8% vs. 9.3%, P < .001).
- Adjusted analysis showed a 64% reduction in endpoint events with IFN-α-2b (HR, 0.36; 95% CI, 0.21-0.62).
- Early IFN-α-2b (0-2 days post-symptom onset) was associated with better outcomes; delayed treatment increased risk.
Conclusions:
- IFN-α-2b aerosol inhalation may improve clinical outcomes in COVID-19.
- Delayed IFN-α-2b intervention is linked to higher probabilities of adverse events.
- Randomized clinical trials are necessary to confirm these findings.
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