Retrospective Multicenter Cohort Study Shows Early Interferon Therapy Is Associated with Favorable Clinical Responses in COVID-19 Patients

Cell Host Microbe. 2020 Sep 9;28(3):455-464.e2. doi: 10.1016/j.chom.2020.07.005. Epub 2020 Jul 18.

Abstract

Interferons (IFNs) are widely used in treating coronavirus disease 2019 (COVID-19) patients. However, a recent report of ACE2, the host factor mediating SARS-Cov-2 infection, identifying it as interferon-stimulated raised considerable safety concern. To examine the association between the use and timing of IFN-α2b and clinical outcomes, we analyzed in a retrospective multicenter cohort study of 446 COVID-19 patients in Hubei, China. Regression models estimated that early administration (≤5 days after admission) of IFN-α2b was associated with reduced in-hospital mortality in comparison with no admission of IFN-α2b, whereas late administration of IFN-α2b was associated with increased mortality. Among survivors, early IFN-α2b was not associated with hospital discharge or computed tomography (CT) scan improvement, whereas late IFN-α2b was associated with delayed recovery. Additionally, early IFN-α2b and umifenovir alone or together were associated with reduced mortality and accelerated recovery in comparison with treatment with lopinavir/ritonavir (LPV/r) alone. We concluded that administration of IFN-α2b during the early stage of COVID-19 could induce favorable clinical responses.

Keywords: RNA virus; anti-retroviral agents; anti-viral immunity; cytokine storm syndrome; infectious disease; respiratory medicine; viral infection.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / therapeutic use
  • Betacoronavirus*
  • COVID-19
  • Child
  • China / epidemiology
  • Cohort Studies
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / mortality
  • Drug Therapy, Combination
  • Female
  • Hospital Mortality
  • Host Microbial Interactions / drug effects
  • Humans
  • Indoles / administration & dosage
  • Interferon-alpha / administration & dosage
  • Interferon-alpha / therapeutic use*
  • Length of Stay
  • Lopinavir / administration & dosage
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / mortality
  • Retrospective Studies
  • Ritonavir / administration & dosage
  • SARS-CoV-2
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents
  • Indoles
  • Interferon-alpha
  • Interferon-alpha2b
  • Lopinavir
  • umifenovir
  • Ritonavir

Supplementary concepts

  • COVID-19 drug treatment