مقالات پذیرفته شده در هفتمین کنگره بین المللی زیست پزشکی
Comparison of interferon beta and the combination of interferon beta and atazanavir-ritonavir in moderate cases of COVID-19
Comparison of interferon beta and the combination of interferon beta and atazanavir-ritonavir in moderate cases of COVID-19
Fatemeh Kourkinejad Gharaei,1Mahdi Rafiyan,2Maedeh Najafizadeh,3,*Hamed Pahlavani,4
1. Student research committee, Kashan university of medical science, Kashan, Iran 2. Student research committee, Kashan university of medical science, Kashan, Iran 3. Department of Infectious Disease, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran 4. Department of Anesthesiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
Introduction: In 2019, covid-19 emerged as a virus targeted respiratory tract and led to the acute respiratory distress syndrome and death. During its pandemic, investigation on antiviral drugs became one of the important research fields. Several drugs have gone under clinical trials and their efficacy against Covid-19 have been assessed and even some of them were imported into guidelines. Moreover, interferons such as interferon beta are another aspect of treatment of this diseases. Recently, studies showed that Atazanavir-Ritonavir along with interferon beta could be used against covid-19. In this study we aimed to compare the efficacy of this antiviral agent with interferon beta.
Methods: This descriptive cross-sectional study was conducted on patients with moderate respiratory involvement due to covid-19 in Shahid Beheshti hospital in 2020. All of the patients above 18 years old were treated with standard national protocol for Covid-19 and their treatment was followed for 4 weeks. Treatments which had been used by these patients were retrieved from pharmacies and was assessed. Patients were divided to two groups based on their consumable drugs: Patients who used Interferon Beta-1 (with brand name Recigen), patients who used interferon Beta-2(with brand name Ziferon), patients who used interferon in combination with Atazanavir-ritonavir. Then demographic variables including age, sex, duration of fever cessation, duration of hospitalization, need for intubation, mechanical ventilation, duration of hospitalization in ICU, final outcome including death or recovery and underlying disease including diabetes, blood pressure, heart and lung disease were extracted and analyzed.
Results: In this study, 135 patients, 65 men (48.15%) and 70 women (51.85%), with an average age of 51.26±16.85 years participated. 42 of the participants received interferon (31.1%) and 93 (68.9%) received INT/ATV. The body temperature of the patients at the time of admission was 37.23 ± 0.82 and at the time of discharge was 36.54 ± 0.37 degrees Celsius, and the systolic blood pressure was 121.93 ± 17.96 at the time of admission and at the time of discharge it was 123.18 ± 11.73 mm Hg. Diastolic blood pressure was 77.73 ± 10.70 mm Hg at the time of admission and 73.54 ± 10.54 mm Hg at the time of discharge. Blood oxygen saturation of the patients was 95.59±2.11% at the time of admission and 96.6%±2.01% at the time of discharge. The heart rate of the patients was 82.83 ± 14.01 per minute at the time of admission and 75.95 ± 8.75 at the time of discharge. The breathing rate of the patients was 17.73 ± 5.37 per minute at the time of admission and 15.26 ± 1.19 at the time of discharge. The length of hospitalization of the patients was on average 5.97 ± 2.77 days and the length of hospitalization in ICU was 10.4 ± 3.53 days. 49 participants (42.7%) had findings positive for COVID_19 on their chest CT image. PCR results were positive for 90 (60%) patients. There were no cases of intubation among the patients. 5 patients (3.7%) were admitted to ICU and 4 patients (3%) died. In this study, the most common underlying diseases were, respectively, 26 people (19.3%) had diabetes, 24 people (17.8%) had high blood pressure, and 12 people (8.9%) had hyperlipidemia. By examining the age of the patients admitted to the ICU, we find that the age of the two drug groups of patients had a statistically significant difference from each other, and the average age of the patients taking interferon was significantly higher than the other group (P=0.016). ). Also, it was shown that there was no significant difference between the gender of the patients of the two medication groups admitted to the ICU (P=0.36). In addition, there was no significant difference between the underlying diseases of 5 patients admitted to ICU (P>0.05). The average length of hospitalization in patients who took INT/ATV drug (5.44±2.45) was significantly lower than the group of patients who took interferon alone (7.14±3.1) (p=0.001). We did not observe any difference between the two drug groups in terms of mortality due to corona virus (P=0.407).
Conclusion: In the conducted study, we found that the length of hospitalization and admission to ICU was shorter in patients in the azatanavir/ritonavir group than in the interferon group. However, the mortality rate was not significantly different between the two groups. Due to the lack of a definitive treatment suitable for each stage of the severity of the disease and also due to the contradictory results of various studies regarding the effectiveness of treatment with interferon or interferon together with azatanavir/ritonavir, more research is needed in this regard to achieve an effective treatment. It is necessary for the disease of COVID_19. It is recommended that in future studies, patients with different levels of disease severity, larger sample size and investigation on other antiviral drugs are also used.