Clinical Pharmacy Department, Pharmacy Services Administration, King Fahad Medical City, Riyadh, Saudi Arabia.
Infectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia.
PLoS One. 2021 Jun 10;16(6):e0252984. doi: 10.1371/journal.pone.0252984. eCollection 2021.
Our study aims at comparing the efficacy and safety of IFN-based therapy (lopinavir/ritonavir, ribavirin, and interferon β-1b) vs. favipiravir (FPV) in a cohort of hospitalized patients with non-critical COVID-19.
Single center observational study comparing IFN-based therapy (interferon β-1b, ribavirin, and lopinavir/ritonavir) vs. FPV in non-critical hospitalized COVID-19 patients. Allocation to either treatment group was non-random but based on changes to national treatment protocols rather than physicians' selection (quasi-experimental). We examined the association between IFN-based therapy and 28-day mortality using Cox regression model with treatment as a time-dependent covariate.
The study cohort included 222 patients, of whom 68 (28%) received IFN-based therapy. Antiviral therapy was started at a median of 5 days (3-6 days) from symptoms onset in the IFN group vs. 6 days (4-7 days) for the FPV group, P <0.0001. IFN-based therapy was associated with a lower 28-day mortality as compared to FPV (6 (9%) vs. 18 (12%)), adjusted hazard ratio [aHR] (95% Cl) = 0.27 (0.08-0.88)). No difference in hospitalization duration between the 2 groups, 9 (7-14) days vs. 9 (7-13) days, P = 0.732 was found. IFN treated group required less use of systemic corticosteroids (57%) as compared to FPV (77%), P = 0.005 after adjusting for disease severity and other confounders. Patients in the IFN treated group were more likely to have nausea and diarrhea as compared to FPV group (13%) vs. (3%), P = 0.013 and (18%) vs. (3%), P<0.0001, respectively.
Early IFN-based triple therapy was associated with lower 28-days mortality as compared to FPV.
本研究旨在比较基于干扰素的治疗（洛匹那韦/利托那韦、利巴韦林和干扰素β-1b）与法匹拉韦（FPV）在非危重新冠肺炎住院患者中的疗效和安全性。
这是一项比较非危重新冠肺炎住院患者中基于干扰素的治疗（干扰素β-1b、利巴韦林和洛匹那韦/利托那韦）与 FPV 的单中心观察性研究。两组患者的分配并非随机，而是基于国家治疗方案的变化，而不是医生的选择（准实验）。我们使用 Cox 回归模型，以治疗作为时变协变量，检查基于干扰素的治疗与 28 天死亡率之间的关联。
研究队列包括 222 名患者，其中 68 名（28%）接受了基于干扰素的治疗。在 IFN 组，抗病毒治疗开始于症状出现后中位数 5 天（3-6 天），而在 FPV 组则为 6 天（4-7 天），P<0.0001。与 FPV 相比，基于干扰素的治疗与较低的 28 天死亡率相关（6 [9%] vs. 18 [12%]），调整后的危险比（95%置信区间）= 0.27（0.08-0.88））。两组的住院时间无差异，分别为 9（7-14）天和 9（7-13）天，P=0.732。调整疾病严重程度和其他混杂因素后，与 FPV 相比，IFN 治疗组使用全身皮质类固醇的比例较低（57%），而 FPV 组为 77%，P=0.005。与 FPV 组相比，IFN 治疗组患者更易出现恶心和腹泻（13% vs. 3%），P=0.013，以及（18% vs. 3%），P<0.0001。
与 FPV 相比，早期基于干扰素的三联疗法与较低的 28 天死亡率相关。
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