Abstract
Background
Currently, there are no drugs that have been proven to be effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Because of its broad antiviral activity, interferon (IFN) should be evaluated as a potential therapeutic agent for treatment of coronavirus disease 2019 (COVID-19), especially while COVID-19-specific therapies are still under development.
Methods
Confirmed COVID-19 patients hospitalized in the First Affiliated Hospital, School of Medicine, Zhejiang University in Hangzhou, China, from January 19 to February 19, 2020 were enrolled in a retrospective study. The patients were separated into an IFN group and a control group according to whether they received initial IFN-α2b inhalation treatment after admission. Propensity-score matching was used to balance the confounding factors.
Results
A total of 104 confirmed COVID-19 patients, 68 in the IFN group and 36 in the control group, were enrolled. Less hypertension (27.9% vs. 55.6%, P=0.006), dyspnea (8.8% vs. 25.0%, P=0.025), or diarrhea (4.4% vs. 19.4%, P=0.030) was observed in the IFN group. Lower levels of albumin and C-reactive protein and higher level of sodium were observed in the IFN group. Glucocorticoid dosage was lower in the IFN group (median, 40 vs. 80 mg/d, P=0.025). Compared to the control group, fewer patients in the IFN group were ventilated (13.2% vs. 33.3%, P=0.015) and admitted to intensive care unit (ICU) (16.2% vs. 44.4%, P=0.002). There were also fewer critical patients in the IFN group (7.4% vs. 25.0%, P=0.017) upon admission. Although complications during admission process were comparable between groups, the discharge rate (85.3% vs. 66.7%, P=0.027) was higher and the hospitalization time (16 vs. 21 d, P=0.015) was shorter in the IFN group. When other confounding factors were not considered, virus shedding time (10 vs. 13 d, P=0.014) was also shorter in the IFN group. However, when the influence of other factors was eliminated using propensity score matching, virus shedding time was not significantly shorter than that of the control group (12 vs. 15 d, P=0.206).
Conclusions
IFN-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients.
摘 要
目 的
分析干扰素-α2b (IFN-α2b) 喷雾吸入治疗对严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 在呼吸道病毒脱落时间的影响.
创新点
IFN 在 2019 冠状病毒病 (COVID-19) 中的治疗价值尚未得到验证.
方 法
我们进行了一项回顾性研究, 纳入 2020 年 1 月 19 日至 2 月 19 日在中国杭州浙江大学医学院附属第一医院住院的 104 例确诊的 COVID-19 患者. 根据入院时是否接受了初始 IFN-α2b 喷雾吸入治疗, 将患者分为 IFN 组和对照组. 采用倾向性得分匹配方法平衡混杂因素后, 比较两组间住院时间和病毒脱落时间的差异.
结 论
IFN-α2b 喷雾吸入不能缩短 COVID-19 住院患者的住院时间和 SARS-CoV-2 的病毒脱毒时间.
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Authors and Affiliations
Contributions
Shao-rui HAO coordinated the work and took the lead in drafting the manuscript and interpreting. Ren YAN, Jiang-shan LIAN, and Huan CAI developed the statistical methods. Shan-yan ZHANG, Xiao-li ZHANG, Lin ZHENG, Hong-yu JIA, Jian-hua HU, Guo-dong YU, Jue-qing GU, Chan-yuan YE, Ci-liang JIN, Ying-feng LU, and Jiao-jiao XIN were participated in the collection of experimental data. Yi-da YANG and Ji-fang SHENG designed the study and reviewed the manuscript prior to submission. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. All authors have read and approved the final manuscript and, therefore, have full access to all the data in the study and take responsibility for the integrity and security of the data.
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Shao-rui HAO, Ren YAN, Shan-yan ZHANG, Jiang-shan LIAN, Huan CAI, Xiao-li ZHANG, Lin ZHENG, Hong-yu JIA, Jian-hua HU, Guo-dong YU, Jue-qing GU, Chan-yuan YE, Ci-liang JIN, Ying-feng LU, Jiao-jiao XIN, Ji-fang SHENG, and Yi-da YANG declare that they have no conflict of interest.
This study was conducted in accordance with the guidelines of the Helsinki Declaration of 1975, as revised in 2008 (5), and was approved by the Clinical Research Ethics Committee of the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China (No. IIT20200005C). Written informed consent was waived by the ethics commission for this retrospective study.
Additional information
Project supported by the National Natural Science Foundation of China (No. 81700549), the National Major Science and Technology Research Projects for the Control and Prevention of Major Infectious Diseases in China (No. 2017ZX10202202), and the Medical and Health Research Program of Zhejiang Province (No. 2015KYB144), China
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Hao, Sr., Yan, R., Zhang, Sy. et al. Interferon-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients: a preliminary matched case-control study. J. Zhejiang Univ. Sci. B 21, 628–636 (2020). https://doi.org/10.1631/jzus.B2000211
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DOI: https://doi.org/10.1631/jzus.B2000211
Key words
- Coronavirus disease 2019 (COVID-19)
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
- Propensity score match
- Interferon (IFN)