Interferon-α2b induced anemia in severe coronavirus disease 2019 patients: a single centered, retrospective study

Immunopharmacol Immunotoxicol. 2021 Dec;43(6):644-650. doi: 10.1080/08923973.2021.1992634. Epub 2021 Oct 26.

Abstract

Background: The current outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread throughout the world. During treatment, we found that the majority of patients had a decrease in hemoglobin (Hb). Interferon-α2b (IFN-α2b) was the primary suspected drug that was related to Hb reduction. Thus, the study aimed to investigate whether IFN-α2b could induce Hb reduction in severe patients with COVID-19 and its potential mechanism.

Material and methods: A total of 50 patients who were admitted to the First Affiliated Hospital of Harbin Medical University with severe COVID-19 infection were enrolled from February 12th to 24th, 2020. The demographics, baseline characteristics, clinical data, and therapeutic regimen were collected retrospectively. The patients were divided into two groups according to the declined use of IFN-α2b on day 14. The Hb levels on admission, day 7, day14, and day 21 were collected and analyzed. The primary endpoint was the level of Hb on day 21.

Results: A total of 31 patients in the IFN-stop group and 19 patients in the non-IFN-stop group were reviewed. The age, gender, comorbidities, clinical symptoms, nutritional status, disease severity, complications, and other factors of the patients were compared, no difference was found between the IFN-stop group and the non-IFN-stop group. The Hb levels of all patients significantly decreased on day 7 compared with that on admission (p < .0001). In the IFN-stop group, the Hb level was increased in 7 days after IFN-α2b was stopped (p = .0008), whereas no difference was found between day 14 and day 21 in the non-IFN-stop group (p = .3152).

Conclusions: IFN-α2b was associated with Hb reduction in the treatment of severe patients of COVID-19. Clinicians should be aware of the high incidence of Hb reduction for patients treated by IFN-α2b.

Keywords: Interferon-α2b; adverse drug reaction; coronavirus disease 2019; hemoglobin reduction.

MeSH terms

  • Administration, Inhalation
  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia / blood
  • Anemia / chemically induced*
  • Anemia / diagnosis
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects*
  • Biomarkers / blood
  • COVID-19 / diagnosis
  • COVID-19 / immunology
  • COVID-19 / virology
  • COVID-19 Drug Treatment*
  • China
  • Female
  • Hemoglobins / metabolism
  • Host-Pathogen Interactions
  • Humans
  • Interferon alpha-2 / administration & dosage
  • Interferon alpha-2 / adverse effects*
  • Male
  • Middle Aged
  • Nebulizers and Vaporizers
  • Retrospective Studies
  • SARS-CoV-2 / drug effects*
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / pathogenicity
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents
  • Biomarkers
  • Hemoglobins
  • Interferon alpha-2
  • Interferon-alpha2b