Impact of Early Interferon-β Treatment on the Prognosis of Patients with COVID-19 in the First Wave: A Post Hoc Analysis from a Multicenter Cohort

Abstract

Background: Interferon-p is an attractive drug for repurposing and use in the treatment of COVID-19, based on its in vitro antiviral activity and the encouraging results from clinical trials. The aim of this study was to analyze the impact of early interferon-p treatment in patients admitted with COVID-19 during the first wave of the pandemic. Methods: This post hoc analysis of a COVID-19@Spain multicenter cohort included 3808 consecutive adult patients hospitalized with COVID-19 from 1 January to 17 March 2020. The primary endpoint was 30-day all-cause mortality, and the main exposure of interest was subcutaneous administration of interferon-beta, defined as early if started <= 3 days from admission. Multivariate logistic and Cox regression analyses were conducted to identify the associations of different variables with receiving early interferon-beta therapy and to assess its impact on 30-day mortality. A propensity score was calculated and used to both control for confounders and perform a matched cohort analysis. Results: Overall, 683 patients (17.9%) received early interferon-p therapy. These patients were more severely ill. Adjusted HR for mortality with early interferon-p was 1.03 (95% CI, 0.82-1.30) in the overall cohort, 0.96 (0.82-1.13) in the PS-matched subcohort, and 0.89 (0.60-1.32) when interferon-beta treatment was analyzed as a time-dependent variable. Conclusions: In this multicenter cohort of admitted COVID-19 patients, receiving early interferon-beta therapy after hospital admission did not show an association with lower mortality. Whether interferon-beta might be useful in the earlier stages of the disease or specific subgroups of patients requires further research.