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

Objective: To assess the efficacy and safety of ribavirin and interferon-alpha (RBV/IFN-alpha) therapy in COVID-19 patients. Methods: A multicenter, retrospective cohort study of COVID-19 patients admitted to 4 hospitals in Hubei Province, China, from 31 December 2019 to 31 March 2020. Patients were divided into 2 groups according to their exposure to RBV/IFN-alpha therapy within 48 h of admission. Mixed-effect Cox model and Logistic regression were used to explore the association between early treatments of RBV/IFN-alpha and primary outcomes. Results: Of 2037 patients included, 1281 received RBV/IFN-alpha (RBV, IFN-alpha or RBV combined with IFN-alpha) treatments and 756 received none of these treatments. In a mixed effect model, RBV/IFN-alpha therapy was not associated with progression from non-severe into severe type (adjusted hazard ratio (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 hospital stay >15 days (adjusted odds ratio (aOR) = 2.11, 95% CI: 1.68-2.64) compared with no RBV/IFN-alpha therapy. The propensity score-matched cohort and subgroup analysis displayed similar results. Conclusion: RBV/IFN-alpha therapy was not observed to improve clinical outcomes in COVID-19 patients suggesting that RBV/IFN-alpha therapy should be avoided in COVID-19 treatment. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-ncnd/4.0/).