Combination therapy of IFNβ1 with lopinavir-ritonavir, increases oxygenation, survival and discharging of sever COVID-19 infected inpatients.
Combination therapy of IFNβ1 with lopinavir-ritonavir, increases oxygenation, survival and discharging of sever COVID-19 infected inpatients.
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IFNβ1与洛匹那韦-利托那韦的联合治疗，增加了严重COVID-19感染住院患者的氧合，生存和出院。
DOI：
10.1016/j.intimp.2020.107329
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发表时间：
2021-03
影响因子：
5.6
通讯作者：
Tabarsi P
中科院分区：
文献类型：
--
作者：
Baghaei P;Dastan F;Marjani M;Moniri A;Abtahian Z;Ghadimi S;Valizadeh M;Heshmatnia J;Sadat Mirenayat M;Abedini A;Kiani A;Eslaminejad A;MohammadReza Hashemian S;Jamaati H;Zali A;Akbar Velayati A;Tabarsi P
干扰素β -1a （IFN-β1-a）是一种具有抗病毒作用的免疫调节介质，已在体内和体外显示出活性，特别是对包括SARS-CoV-2在内的冠状病毒。COVID-19被定义为由SARS-CoV-2感染引起的疾病。该病毒抑制炎症细胞产生IFN-β1-a。我们对2020年2月19日至4月30日期间在Masih Daneshvari医院作为COVID-19指定医院接受洛匹那韦/利托那韦治疗的所有成年确诊COVID-19住院患者进行了回顾性研究，这些患者每12小时接受三次剂量的1200万国际单位IFN-β1-a和洛匹那韦400 mg和利托那韦100 mg的联合治疗（病例组），持续14天。通过多变量分析确定IFN-β1-a对预后和全因死亡率的影响。IFN-β1-a组152例，对照组304例。与对照组相比，IFN-β1-a组住院时间更长，需要无创通气的时间更长（13天对6天，p = 0.001），需要无创通气的时间更长（34%对24%，p = 0.04）。治疗期间，57例（12.5%）患者死亡。病例组和对照组的死亡率分别为11%和13%。在多变量分析中，未接受IFN-β1-a治疗（HR 5.12, 95% CI: 2.77 - 9.45）、共病（HR 2.28, 95% CI: 1.13-4.60）和无创通气（HR 2.77, 95% CI: 1.56-4.93）仍与全因死亡率显著相关。在本研究中，使用IFN-β1-a可降低COVID-19患者的死亡风险。需要更多的临床研究来衡量IFN-β1-a在COVID-19治疗中的疗效。
Interferon Beta-1a (IFN-β1-a), an immunomodulatory mediator with antiviral effects, has shown in vivo and in vitro activities especially on coronavirus including SARS-CoV-2. COVID-19 defined as the disease caused by infection with SARS-CoV-2. The virus has been illustrated inhibits the production of IFN-β1-a from inflammatory cells. We conducted a retrospective study of all adult confirmed COVID-19 hospitalized patients who received combination of three doses of 12 million international units of IFN-β1-a and Lopinavir 400 mg and Ritonavir 100 mg every 12 h (case group) for 14 days besides standard care and age- and sex- matched COVID-19 patients with receiving lopinavir/ritonavir (control group) at Masih Daneshvari Hospital as a designated hospital for COVID-19 between Feb 19 and Apr 30, 2020. Multivariate analysis was done to determine the impact of IFN-β1-a on outcome and all-cause mortality. 152 cases in IFN-β1-a group and 304 cases as control group were included. IFN-β1-a group stayed at hospital longer and required noninvasive ventilation more than control group (13 vs. 6 days, p = 0.001) and (34% vs. 24%, p = 0.04), respectively. During treatment, 57 (12.5%) patients died. The death rate in case and control groups was 11% and 13% respectively. In multivariate analysis, not receiving IFN-β1-a (HR 5.12, 95% CI: 2.77–9.45), comorbidity (HR 2.28, 95% CI: 1.13–4.60) and noninvasive ventilation (HR 2.77, 95% CI: 1.56–4.93) remained significantly associated with all-cause mortality. In this study, risk of death decreased by using IFN-β1-a in COVID-19 patients. More clinical study will be necessary to measure efficacy of IFN-β1-a in COVID-19 treatment.
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