Categories
COVID-19

Hong Kong Combination Therapy Trial Shows Improved Outcomes

Transmission Electron Microscope Image of SARS-CoV-2
NIAID / CC BY (https://creativecommons.org/licenses/by/2.0)

Very briefly tonight because it’s late. The docs at MGH FLARE presented a study out of Hong Kong showing significant improvements in recovery time for patients with COVID-19.

The study, a randomized trial, looked at combination treatment with Interferon beta-1b and two anti-viral medications, lopinavir-ritonavir and ribavirin. Interferon beta-1b is part of the innate immune response and it’s utility as an anti-viral has been studied before including during MERS-CoV when it helped speed recovery. Ribavirin is a medication that inhibits viral replication and has been used to treat viral infections for years. Lopinavir-ritonavir is a protease inhibitor created to fight HIV.

The three medications when used together and given early in the course of the infection improved time from start of treatment to negative nasopharyngeal swab (7 days in study group, 12 days in control). Similarly, statistically significant improvements in time to resolution of symptoms as measured by NEWS2 score (4 days in study group, 8 days in control), shorter time to SOFA (Sequential Organ Failure Assessment) score of 0 (3 days in study group, 8 days in control) and shorter mean hospital stays (9 days in study group, 14 days in control). No deaths occurred in the control or study group so differences in mortality couldn’t be assessed.

I find these results very exciting. It’s still early and larger randomized trials will tell us more but the hypothesis shared by many that combination therapies might be the best approach to finding a successful treatment regimen for COVID-19 seems to be bearing fruit in this study.