{"id":38030,"date":"2020-06-01T07:35:38","date_gmt":"2020-06-01T07:35:38","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=38030"},"modified":"2020-06-01T15:56:35","modified_gmt":"2020-06-01T15:56:35","slug":"treatment-with-interferon-in-early-covid-19","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/38030","title":{"rendered":"Treatment with interferon in early COVID-19"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/span><\/strong><\/p>\n

Two studies have been recently published that report potential benefits from using interferon treatment in mild or early COVID-19.<\/span><\/strong><\/p>\n

A study by Zhou and colleagues reported the outcomes of 77 participants with moderate COVID-19 who were admitted to the <\/span>Union Hospital in Shanghai between 16 January and 20 February 2020 and who were randomised to receive either nebulised IFN-\u03b1-2b (n=7), the antiviral <\/span>umifenovir (UFV) (n=24) or dual treatment (n=46). [1]<\/p>\n

Participants receiving IFN treatment had faster viral load clearance and reduced levels of inflammatory proteins IL-6 and C-reactive protein, regardless of age, sex and comorbidities.<\/span>\u00a0<\/span><\/span><\/p>\n

Baseline characteristics that varied between groups included median age (IQR) 41 vs 40 vs 64 (p<0.001) the percentage of men 0%, 43% and 45% (p=0.076) and percentage with comorbidities 14%, 15% and 54% (p=0.002), in the IFN, dual and UFV arms respectively.<\/span><\/span><\/p>\n

The dual therapy group was also treated approximately nine days later after symptoms, median 8, 17 and 8 days respectively, p=0.004. <\/span><\/span><\/p>\n

None of the participants required<\/span> oxygen supplementation, intubation or intensive care. Approximately 50% had fever 38\u00b0C that was managed by ibuprofen.<\/span><\/p>\n

Mean days to viral clearance was approximately 21 vs 20 vs 28 days from the onset of symptoms for the IFN, dual and UFV arms respectively (p-0.002).<\/span><\/p>\n

The dual therapy arms included <\/span>16\/46 cases (34.8%) IFN was started after UFV and 24 cases where IFN was continued after UFV was stopped.<\/p>\n

Although this was an exploratory, small, non-randomised, uncontrolled study with significant baseline differences between the groups the effects of IFN treatment on accelerated viral clearance and reductions in circulating IL-6 and CRP levels remained significant after adjusting for age, sex and comorbidities.\u00a0<\/span><\/p>\n

At least one publication has reported no benefit from using umifenovir (only available in China and Russia) against COVID-19. [2]<\/span><\/p>\n

An open-label, randomised, phase 2 trial from Hung and colleagues using a triple combination regimen of interferon beta-1b, lopinavir\/r and ribavirin reported better outcomes compared to a control arm using lopinavir\/r alone.\u00a0[3]<\/span><\/p>\n

The triple therapy arm had significantly reduced time to negative throat PCR: 7 days (IQR: 5 to 11) vs\u00a012 days (IQR: 8 to 15) [HR: 4.37 (95%CI: 1.86 to 10.24)], symptom alleviation: 0 of 4 days (IQR 3 to 8)\u00a0vs\u00a08 days (IQR: 7 to 9); [HR 3.92; 95%CI: 1.66 to 9.23], and duration of hospital stay (9.0 days (IQR: 7.0 to 13.0]\u00a0vs\u00a014.5 days (IQR: 9\u00b73 to 16\u00b70); HR 2.72 (95%CI: 1.2 to 6.13).\u00a0<\/span><\/p>\n

Although this is important for being a prospective study, participants were in early mild or moderate COVID-19 and there was no mortality in either group.<\/span><\/p>\n

This report was first published on 26 May 2020.<\/em><\/p>\n

References<\/span><\/p>\n

    \n
  1. Zhou Q et al. Interferon-\u03b12b Treatment for COVID-19. Front. Immunol., DOI: 10.3389\/fimmu.2020.01061. (15 May 2020). https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2020.01061\/full <\/span><\/a><\/li>\n
  2. Lian N et al. Umifenovir treatment is not associated with improved outcomes in patients with coronavirus disease 2019: a retrospective study. Clin Bicrociol and Inf. DOI: 10.1016\/j.cmi.2020.04.026. (25 April 2020).
    \n<\/span>    https:\/\/www.clinicalmicrobiologyandinfection.com\/article\/S1198-743X(20)30234-2\/fulltext<\/span><\/a><\/li>\n
  3. Hung IF-N et al. Triple combination of interferon beta-1b, lopinavir\u2013ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. Lancet. 2020; DOI: 10.1016\/S0140-6736(20)31042-4. (8 May 2020).
    \n    https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(20)31042-4\/fulltext<\/a>
    \n<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base Two studies have been recently published that report potential benefits from using interferon treatment in mild or early COVID-19. A study by Zhou and colleagues reported the outcomes of 77 participants with moderate COVID-19 who were …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[283,278],"tags":[],"class_list":["post-38030","post","type-post","status-publish","format-standard","hentry","category-covid-19-investigational-drugs","category-covid-19"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/38030","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=38030"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/38030\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=38030"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=38030"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=38030"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}