Interferon-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients: a preliminary matched case-control study
Interferon-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients: a preliminary matched case-control study
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干扰素-α 2b 喷雾吸入并未缩短住院患者 SARS-CoV-2 的病毒排毒时间：初步匹配病例对照研究
DOI：
10.1631/jzus.b2000211
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发表时间：
2020-08-01
影响因子：
5.1
通讯作者：
Yang, Yi-da
中科院分区：
文献类型：
--
作者：
Hao, Shao-rui;Yan, Ren;Yang, Yi-da
目前，尚无对严重急性呼吸综合症冠状病毒2（SARS-COV-2）有效的药物。由于其广泛的抗病毒活性，应将干扰素（IFN）评估为治疗冠状病毒疾病2019（COVID-19）的潜在治疗剂，尤其是当COVID-19特异性疗法仍在开发中。方法证实，从1月19日至2020年2月19日，在中国杭州钟州的第一家附属医院医学院住院的COVID-19患者被录取了一项回顾性研究。根据入院后是否接受了初始的IFN-Alpha 2B吸入治疗，将患者分为IFN组和对照组。倾向得分匹配用于平衡混杂因素。结果总共招募了104名确认的COVID-19患者，IFN组为68例，对照组招募了36例。在IFN组中观察到较少的高血压（27.9％对55.6％，P = 0.006），呼吸困难（8.8％vs. 25.0％，P = 0.025）或腹泻（4.4％，19.4％，P = 0.030）在IFN组中观察到。在IFN组中观察到较低的白蛋白和C反应蛋白以及较高水平的钠。 IFN组的糖皮质激素剂量较低（中值，40 mg/d，p = 0.025）。与对照组相比，IFN组的患者较少（13.2％vs. 33.3％，p = 0.015），并进入重症监护病房（ICU）（ICU）（16.2％vs. 44.4％，p = 0.002）。入院后，IFN组的关键患者也更少（7.4％比25.0％，p = 0.017）。尽管在入院过程中的并发症之间是可比的，但排放率（85.3％vs. 66.7％，p = 0.027）较高，而住院时间（16 vs. 21 D，p = 0.015）在IFN组中更短。当不考虑其他混杂因素时，在IFN组中，病毒脱落时间（10 vs.13 d，p = 0.014）也较短。但是，当使用倾向评分匹配消除其他因素的影响时，病毒脱落时间不及对照组的影响（12 vs.15 d，p = 0.206）。结论IFN-Alpha 2b喷雾吸入并未缩短住院患者的SARS-COV-2病毒时间。
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-alpha 2b 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-alpha 2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients.