Retrospective Multicenter Cohort Study Shows that Early Interferon Therapy is Associated with Favorable Clinical Responses in COVID-19 Patients

Wang, Nan; Zhan, Yan; Zhu, Linyu; Hou, Zhibing; Liu, Feng; Song, Pinhong; Qiu, Feng; Wang, Xiaolin; Zou, Xiafei; Wan, Deyun; Qian, Xiaosong; Wang, Shanshan; Guo, Yabi; Yu, Hao; Cui, Miao; Tong, Gangling; Xu, Yunsheng; Zheng, Zhihua; Lu, Yingying; Hong, Peng

Summary Interferons (IFN) are widely used in treating coronavirus disease 2019 (COVID-19) patients. However, recent report of ACE2, the host factor mediating SARS-Cov-2 infection, as interferon-stimulated, raised considerable safety concern. To examine the association between the use and timing of IFN-α2b and clinical outcomes, we analyzed in a retrospective multicenter cohort study 446 COVID-19 patients in Hubei, China. Regression models estimated that early administration (≤5 days after admission) of IFN-α2b was associated with reduced in-hospital mortality compared to no IFN-α2b, while late administration of IFN-α2b was associated with increased mortality. Among survivors, early IFN-α2b was not associated with hospital discharge or CT scan improvement, while late IFN-α2b was associated with delayed recovery. Additionally, early IFN-α2b and umifenovir (UFV) alone or together were associated with reduced mortality and accelerated recovery compared to lopinavir/ritonavir (LPV/r) alone. We concluded that administration of IFN-α2b during the early stage of COVID-19 may induce favorable clinical responses.