The dual role of anti-viral therapy in the treatment of Coronavirus disease 2019

Eur Rev Med Pharmacol Sci. 2020 Nov;24(22):11939-11944. doi: 10.26355/eurrev_202011_23854.

Abstract

Objective: Coronavirus disease 2019 (COVID-19) has become a worldwide public health emergency; unfortunately, there is currently no treatment for improving outcomes or reducing viral-clearance times in infected patients. The aim of the present study was to evaluate the efficacy of interferon (IFN) with or without lopinavir and ritonavir as antiviral therapeutic option for treating COVID-19 infection.

Patients and methods: The present study enrolled 148 patients that received either standard care, treatment with IFN alfa-2b, or IFN alfa-2b combined with lopinavir plus ritonavir. Viral testing was performed using Reverse-Transcription Polymerase Chain Reaction (RT-PCR).

Results: There was no significant difference in the viral-clearance time at 28 days after treatment between patients receiving standard care and those receiving anti-viral treatments. However, the average viral-clearance time of patients receiving standard care (14 days) was shorter than that for patients receiving IFN alfa-2b or IFN alfa-2b combined with lopinavir plus ritonavir (15.5 or 17.5 days) (p<0.05). Patients treated with IFN alfa-2b within five days or IFN alfa-2b combined with lopinavir plus ritonavir after three days of symptoms exhibited shorter viral-clearance times than the other groups (p<0.05). Moreover, viral-clearance times were significantly longer in patients receiving standard care or anti-viral treatment 5 days after symptoms appeared than those of patients who received these treatments within five days of symptom onset (p<0.05).

Conclusions: Early symptomatic treatment is most critical for maximizing amelioration of COVID-19 infection. Anti-viral treatment might have complicated effect on viral-clearance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / therapeutic use*
  • COVID-19 / diagnosis
  • COVID-19 Drug Treatment*
  • COVID-19 Nucleic Acid Testing
  • Cohort Studies
  • Drug Combinations
  • Drug Therapy, Combination
  • Early Medical Intervention*
  • Female
  • Humans
  • Interferon alpha-2 / therapeutic use*
  • Lopinavir / therapeutic use*
  • Male
  • Middle Aged
  • Ritonavir / therapeutic use*
  • Time Factors
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Drug Combinations
  • Interferon alpha-2
  • lopinavir-ritonavir drug combination
  • Lopinavir
  • Ritonavir