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Comparative therapeutic efficacy of interferon alfa-2b and combination lopinavir/ritonavir plus interferon alfa-2b
Jingyuan Liu1, Chunjing Du1, Lin Pu1
1Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshundong Street, Chaoyang District, Beijing, 100015, People's Republic of China.
Background:
The outbreak of coronavirus disease 2019 (COVID-19) posed an enormous threat to public health. The use of antiviral drugs in patients with this disease have triggered people's attentions. Whether interferon alfa-2b or lopinavir/ritonavir (LPV/r) plus interferon alfa-2b treatment can against SARS-CoV-2 was unknown. The objectives of this study was to evaluate the efficacy and safety of interferon alfa-2b and LPV/r plus interferon alfa-2b for SARS-CoV-2 infection in adult patients hospitalized with COVID-19.
Methods:
This is a retrospective cohort study of 123 patients confirmed SARS-CoV-2 infection by PCR on nasopharyngeal swab and symptoms between Jan. 13 and Apr. 23, 2020. All patients received standard supportive care and regular clinical monitoring. Patients were assigned to standard care group (n = 12), interferon alfa-2b group (n = 44), and combination LPV/r plus interferon alfa-2b group (n = 67). The primary endpoints were duration of required oxygen support and virus clearance time. Associations between therapies and these outcomes were assessed by Cox proportional hazards regression.
Results:
Baseline clinical characteristics were not significantly different among the three groups (P > 0.05). No significant associations were observed between LPV/r/interferon alfa-2b and faster SARS-CoV-2 RNA clearance (HR, 0.85 [95% confidence interval (CI) 0.45-1.61]; P = 0.61 in interferon alfa-2b group vs HR, 0.59 [95% CI 0.32-1.11]; P = 0.10 in LPV/r plus interferon alfa-2b group). Individual therapy groups also showed no significant association with duration of required oxygen support. There were no significant differences among the three groups in the incidence of adverse events (P > 0.05).
Conclusions:
In patients with confirmed SARS-CoV-2 infection, no benefit was observed from interferon alfa-2b or LPV/r plus interferon alfa-2b treatment. The findings may provide references for treatment guidelines of patients with SARS-CoV-2 infection.
Insights
Interferon alfa-2b and lopinavir/ritonavir (LPV/r) plus interferon alfa-2b did not improve outcomes for hospitalized COVID-19 patients. These antiviral treatments showed no significant benefit in virus clearance or oxygen support duration.
Area of Science:
- Virology
- Infectious Diseases
- Pharmacology
Background:
- The COVID-19 pandemic necessitated urgent research into effective antiviral treatments.
- The efficacy of interferon alfa-2b and combination lopinavir/ritonavir (LPV/r) plus interferon alfa-2b against SARS-CoV-2 remained uncertain.
- Understanding treatment effects is crucial for managing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections.
Purpose of the Study:
- To evaluate the efficacy of interferon alfa-2b monotherapy for SARS-CoV-2 infection.
- To assess the safety and effectiveness of lopinavir/ritonavir (LPV/r) plus interferon alfa-2b combination therapy.
- To compare these treatments against standard care in hospitalized adult COVID-19 patients.
Main Methods:
- Retrospective cohort study involving 123 hospitalized patients with confirmed SARS-CoV-2 infection.
- Patients were categorized into three groups: standard care (n=12), interferon alfa-2b (n=44), and LPV/r plus interferon alfa-2b (n=67).
- Primary endpoints included duration of oxygen support and virus clearance time, analyzed using Cox regression.
Main Results:
- No significant differences in baseline characteristics were observed among the treatment groups.
- Neither interferon alfa-2b nor the combination LPV/r plus interferon alfa-2b demonstrated significant associations with faster SARS-CoV-2 RNA clearance.
- No significant differences in the duration of oxygen support or incidence of adverse events were found across the groups.
Conclusions:
- Interferon alfa-2b, alone or in combination with LPV/r, showed no discernible benefit for patients with SARS-CoV-2 infection.
- The study suggests these antiviral strategies may not be effective for treating COVID-19.
- Findings may inform future clinical guidelines for managing SARS-CoV-2 infections.
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