Interferon-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients: a preliminary matched case-control study

干扰素-α2b喷雾吸入未缩短住院患者的SARS-CoV-2的脱落时间:一项初步的配对病例对照研究

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-α2 b 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-α2 b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients.

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。