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

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.

Comparison of epidemiological and clinical characteristics of COVID-19 patients with and without Wuhan exposure history in Zhejiang Province,China

Background:A novel coronavirus called severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),first identified in Wuhan,China,has been rapidly spreading around the world.This study investigates the epidemiological and clinical characteristics of coronavirus disease 2019(COVID-19)patients in Zhejiang Province who did or did not have a history of Wuhan exposure.Methods:We collected data from medical records of confirmed COVID-19 patients in Zhejiang Province from Jan.17 to Feb.7,2020 and analyzed epidemiological,clinical,and treatment data of those with and without recorded recent exposure in Wuhan.Results:Patients in the control group were older than those in the exposure group((48.19±16.13)years vs.(43.47±13.12)years,P<0.001),and more were over 65 years old(15.95%control vs.5.60%exposure,P<0.001).The rate of clustered onset was also significantly higher in the control group than in the exposure group(31.39%vs.18.66%,P<0.001).The symptom of a sore throat in patients in the exposure group was significantly higher than that in the control group(17.30%vs.10.89%,P=0.01);however,headache in the exposure group was significantly lower than that in the control group(6.87%vs.12.15%,P=0.015).More patients in the exposure group had a significantly lower level of lactate dehydrogenase(LDH)and aspartate aminotransferase(AST)than those in the control group.There was no significant difference in any degree of COVID-19 including mild,severe,and critical between the two groups.Conclusions:From the perspective of epidemiological and clinical characteristics,there was no significant difference between COVID-19 patients with and without Wuhan exposure history.

Clinical characteristics of different subtypes and risk factors for the severity of illness in patients with COVID-19 in Zhejiang, China

Background The outbreak of coronavirus disease 2019(COVID-19)is now becoming an enormous threat to public health.The clinical spectrum of COVID-19 is extensive,of which critical cases are with rapid disease progression and high mortality.The aim of our study is to summarize the characteristics of different subtypes and explore risk factors of illness severity for early identification and prompt treatment.Methods In this retrospective study,we collected data of patients confirmed COVID-19 in Zhejiang Province from 17 January to 12 February 2020.According to the definition of clinical classification,we divided confirmed cases into four types,and summarize epidemiological and clinical characteristics,laboratory and radiograph findings,treatments,and outcomes,respectively.Moreover,we used univariate and multivariate ordinal logistic regression models to explore risk factors for the severity of illness in patients with COVID-19.Results A total of 788 patients were enrolled in our study,of whom 52 cases(6.6%)were mild type,658 cases(83.5%)were common type,61 cases(7.2%)were severe type,and 17 cases(2.2%)were critical type.Multivariate ordinal logistic regression demonstrated increasing odds of the severity of illness in patients with COVID-19 associated with male(odds ratio[OR]=1.7,95%confidence interval[CI]:1.2–2.6 P=0.008),fever(OR=3.6,95%CI:2.1–6.3,P<0.001),cough(OR=1.7,95%CI:1.0–2.9,P=0.041),hemoptysis(OR=3.4,95%CI:1.1–10.3,P=0.032),gastrointestinal symptoms(OR=1.9,95%CI:1.0–3.5,P=0.047),hypertension(OR=2.6,95%CI:1.2–5.6,P=0.013).With the increase of age-grading,risk for the severity of illness was gradually higher(≤18 years[OR=1.0],19–40 years[OR=12.7,95%CI:4.5–36.0,P<0.001],41–65 years[OR=14.8,95%CI:5.2–42.1,P<0.001],≥66 years[OR=56.5,95%CI:17.1–186.5,P<0.001]).Conclusions Clinicians should pay close attention to these features in patients with COVID-19 including older age,male,fever,cough,hemoptysis,gastrointestinal symptoms and hypertension to identify the severity of illness as early as possible.