Ribavirin therapy for severe COVID-19: a retrospective cohort study

Int J Antimicrob Agents. 2020 Sep;56(3):106114. doi: 10.1016/j.ijantimicag.2020.106114. Epub 2020 Jul 23.

Abstract

The aim of this study was to compare ribavirin therapy versus supportive therapy only for patients with severe coronavirus disease 2019 (COVID-19). A total of 115 patients with laboratory-confirmed COVID-19 were retrospectively analysed. All patients received supportive care as well as regular laboratory and clinical monitoring. The 115 patients comprised 44 patients who received intravenous ribavirin (treatment group) and 71 who did not (control group). Baseline laboratory and clinical characteristics were similar between the two groups. The negative conversion time for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR in the ribavirin group was 12.8 ± 4.1 days compared with 14.1 ± 3.5 days in the control group (P = 0.314). Moreover, 7/41 patients (17.1%) in the ribavirin group died compared with 17/69 (24.6%) in the control group (P = 0.475). Adverse effects were similar between the two groups. In conclusion, in patients with severe COVID-19, ribavirin therapy is not associated with improved negative conversion time for SARS-CoV-2 test and is not associated with an improved mortality rate. Further assessment in designed randomised controlled trials is recommended.

Keywords: 2019 novel coronavirus; COVID-19; Respiratory infection; Ribavirin; SARS-CoV-2; Treatment.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Antiviral Agents / therapeutic use*
  • Betacoronavirus / drug effects*
  • Betacoronavirus / immunology
  • COVID-19
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / mortality
  • Coronavirus Infections / virology
  • Female
  • Humans
  • Immunoglobulins / therapeutic use
  • Male
  • Middle Aged
  • Pandemics
  • Patient Discharge
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / virology
  • Retrospective Studies
  • Ribavirin / therapeutic use*
  • SARS-CoV-2
  • Severity of Illness Index
  • Survival Analysis
  • Time Factors
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Antiviral Agents
  • Immunoglobulins
  • Ribavirin