In patients with severe COVID-19, the antiviral response of type I and III interferons (IFN) is markedly reduced. Clinical studies have shown that IFN administration effectively suppresses hepatitis B and C viruses, reduces mortality and accelerates clinical improvement in SARS and MERS coronaviruses. However, the use of interferons for the treatment of COVID-19 has shown mixed results.

To assess the efficacy and safety of type I and III IFNs for the treatment of patients with COVID-19 of varying severity, Korean scientists conducted a systematic review and meta-analysis of 11 randomized controlled trials involving 6124 patients. In all tests:

  • Participants are adults with COVID-19;
  • treatment included the use of interferons: IFN-α, β and λ;
  • treatment of the control group – placebo or standard therapy.

Interferon Treatment Marginally Reduces Mortality

Nine studies involving 2895 patients in the IFN group and 2869 patients in the placebo and standard therapy groups examined the effect of interferon on 28-day mortality. Compared with the control group, treatment with interferon contributed to a decrease in mortality at day 28, but the impact of IFN was not statistically significant.

Interferon and Mechanical Ventilation

Six studies involving 2744 patients in the IFN group and 2739 in the control group examined the effect of IFN on the market for mechanical ventilation. There were no statistically significant differences between the groups.

Interferon and Side Effects during Treatment

Adverse events were considered: death or life-threatening event, hospitalization, disability or permanent damage, congenital anomalies, additional interventions to prevent irreversible damage, severe allergic reactions, convulsions, or an emergency room visit.

Serious adverse events were reported in nine studies involving 972 patients in the IFN group and 954 in the control group. Interferon did not increase the risk of adverse events.

Interferon Significantly Accelerates Recovery in Severe COVID-19

Four studies examined the effect of interferon on the rate of recovery: 674 patients in the IFN group and 674 in the control group. Treatment with interferon did not lead to clinical improvement on the 14th day. However, inhaled interferon therapy significantly accelerated recovery in patients with moderate to severe COVID-19.

Three studies involving 123 patients in the IFN group and 122 in the control group showed that interferon significantly increased hospital discharge rate at day 14.

A significant result was observed only in patients with severe COVID-19.

Conclusion

Treatment with interferon contributed to a decrease in mortality from coronavirus, but only slightly. Interferon could not prevent the progression of the disease until the need for mechanical ventilation. Future clinical trials should evaluate the efficacy of interferon treatment in patients with mild or earlier disease of COVID-19.

IFN treatment did not worsen the outcomes of patients with severe COVID-19 and was as safe as treatment in the control group, regardless of the severity of the coronavirus. However, in severe COVID-19, late-stage type I IFN response may exacerbate inflammatory reactions and cause lung damage and pneumonia. Therefore, interferon should be administered only in the early stages of coronavirus – up to 5 days from the onset of symptoms.

Although data on the recovery rate with interferon treatment are conflicting, patients in the IFN group were more likely to be discharged from the hospital on the 14th day.

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Reference

Clinical efficacy and safety of interferon (Type I and Type III) therapy in patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

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