Clinical evaluation of IFN beta1b in COVID-19 pneumonia: a retrospective study
Authors: Estébanez Miriam , Ramírez-Olivencia German , Mata Tatiana , Martí David , Gutierrez Carlos , de Dios Begoña , Herrero María Dolores , Roel Ana , Martínez Yolanda , Aguirre Alejandro , Alcántara-Nicolás Francisco , Fernández-González Pablo , López Elena , Ballester Lucía Elena , Mateo-Maestre María , Campos Sergio , Sánchez-Carrillo María Jesús , Fe Antonio , de Novales Francisco Javier Membrillo ,   COVID 19 CENTRAL DEFENSE HOSPITAL “GÓMEZ ULLA” TEAM
Published: May 2020

Background

COVID-19 pneumonia is associated with significant mortality and has no approved antiviral therapy. Interferon beta1 has shown in vitro studies a potent inhibition of SARS-CoV and MERS-CoV. In an in vitro study, SARS-CoV-2 had more sensitivity to IFN-I pretreatment that SARS-CoV. A combination of IFN beta1b administered subcutaneously with other antiviral treatments has been recommended in several guidelines. However, clinical trial results for the treatment of COVID-19 are pending. We aimed to assess the efficiency of IFN beta1b in COVID19 comparing the in-hospital mortality between patients who received IFN beta1b and patients did not receive.

Methods

In this retrospective cohort study, we included hospitalized adults with COVID-19 between February 23th and April 4th, 2020, at the Central Defense Hospital (Madrid, Spain). Subcutaneous interferon beta-1b was recommended in moderate-severe pneumonia. The primary endpoint was in-hospital mortality. Univariate and multivariate analysis was performed to identify variables associated with in-hospital mortality.

Findings

We analyzed 256 patients (106 patients in interferon group and 150 patients in control group). At admission, patients who did not receive interferon beta1b presented a greater number of comorbidities. The overall mortality rate was 24.6% (63/256). Twenty-two patients (20.8%) in the interferon group died and 41 (27.3%) in the control group (p=0.229). In the multivariate analysis, the predictors of in-hospital mortality were age, severity of clinical picture at admission and hydroxychloroquine treatment.

Interpretation

In hospitalized patients with COVID-19, interferon beta1b treatment was not associated to decrease in-hospital mortality. Further assessment of the earlier administration of this drug in randomized trials is recommended.

Funding

none.

RESEARCH IN CONTEXT

Evidence before this study

We searched Pubmed on April 27th, 2020, for articles evaluating the efficacy of interferon beta in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using the terms: “interferon beta and (COVID-19 or SARS-CoV-2)”. We only found 5 articles. Of them, there was only one original article in English, which was a descriptive study of a case series with solid organ transplant from Spain.

Added value of this study

This is the first article that reports the efficacy of interferon beta1b in the treatment of patients with COVID-19. We compared the in-hospital mortality between patients who received interferon beta1b and patients who did not. Patients in both groups received other drugs with a potential antiviral and immunomodulatory effect. There was no significant difference in in-hospital mortality between both groups.

Implications of all the available evidence

In our retrospective cohort, treatment with interferon beta1b had not impact on in-hospital survival, however it would be of clinical interest to evaluate the effect of early administration of this drug in the control of SARS-CoV-2 infection in larger randomized clinical trials.