Interferon‐α‐2b aerosol inhalation is associated with improved clinical outcomes in patients with coronavirus disease‐2019

Yu, Jiong; Lu, Xuan; Tong, Ling; Shi, Xiaowei; Ma, Jing; Lv, Feifei; Wu, Jian; Pan, Qiaoling; Yang, Jinfeng; Cao, Hongcui; Li, Lanjuan

AIMS: Type 1 interferon (IFN) is used to treat patients with coronavirus disease‐2019 (COVID‐19) but robust supporting evidence is lacking. We investigated the association between IFN‐α‐2b and the clinical outcomes of patients with COVID‐19. METHODS: A total of 1401 patients were enrolled, with 852 (60.8%) patients receiving 5 000 000 U of IFN‐α‐2b via aerosol inhalation twice daily. The primary outcome was a composite measure consisting of mechanical ventilation, intensive care unit (ICU) admission and death. A subgroup analysis was performed to investigate the impact of the IFN‐α‐2b initiation schedule on symptom onset. RESULTS: The risk probability for crude endpoints was lower in the IFN‐α‐2b group (3.8%) than in the non‐IFN‐α‐2b group (9.3%, P < .001). After adjusting the confounding factors, IFN‐α‐2b therapy achieved a reduction of 64% in occurrence of endpoint events (hazard ratio, 0.36; 95% confidence interval [CI], 0.21–0.62). In the subgroup analysis, compared with patients who received IFN‐α‐2b treatment 0–2 days after symptom onset, the hazard ratio for endpoints was 2.2 (95% CI, 0.43–11.13) in patients who received the therapy 3–5 days after symptom onset, 5.89 (95% CI, 0.99–35.05) in patients who received the therapy 6–8 days after symptom onset, and remained at a high level thereafter. CONCLUSIONS: IFN‐α‐2b aerosol inhalation therapy may be associated with improved clinical outcomes in patients with COVID‐19, and delayed IFN‐α‐2b intervention was associated with increased probabilities of risk events. Further randomized clinical trials are needed to validate the preliminary findings of this study.