Efficacy of ribavirin and interferon-α therapy for hospitalized patients with COVID-19: a multicenter, retrospective cohort study

Li, Hui; Xiong, Nian; Li, Changjun; Gong, Yanhong; Liu, Li; Yang, Heping; Tan, Xiangping; Jiang, Nan; Zong, Qiao; Wang, Jing; Lu, Zuxun; Yin, Xiaoxv

OBJECTIVE: To assess the efficacy and safety of ribavirin and interferon-α (RBV/IFN-α) therapy in patients with COVID-19. METHODS: This multi-center, retrospective cohort study included patients with COVID-19 admitted to four hospitals in Hubei Province, China, from 31 December, 2019 to 31 March, 2020. Patients were divided into two groups according to their exposure to RBV/IFN-α therapy within 48 hours of admission. Mixed-effect Cox model and Logistic regression were used to explore the association between early treatments of RBV/IFN-α with primary outcomes. RESULTS: Of 2037 patients eventually included, 1281 patients received RBV/IFN-α (RBV alone/IFN-α alone/RBV combined with IFN-α) treatments and 756 patients received none of these treatments. In mixed effect model, RBV/IFN-α therapy was not associated with progression from non-severe into severe type (aHR = 1.09, 95%CI: 0.88-1.36) or with reduction in 30-day mortality (aHR = 0.89, 95%CI: 0.61-1.30). However, it was associated with a higher probability of length of hospital stay over 15 days (aOR = 2.11, 95%CI: 1.68-2.64) compared with No RBV/IFN-α therapy. Moreover, the propensity score-matched cohort and subgroup analysis displayed similar results. CONCLUSION: RBV/IFN-α therapy was not observed to any benefit in improving clinical outcomes in patients with COVID-19, suggesting that RBV/IFN-α therapy should be avoided in COVID-19 patients.