Introduction
COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), posed an enormous threat to public health1-4. Since the first case with SARS-CoV-2 was published in December 2019, the laboratory-confirmed cases are continuously escalating day to day and spread like wildfire to more than 200 countries and territories5, 6. COVID-19 cases are frequently associated with respiratory and multiorgan dysfunction that result in deaths7-9. Accordingly, the use of antiviral drugs in patients with this disease have triggered questions and whether currently antiviral drugs could be effectively cured this disease prompts a critical consideration.
Based on results from previous research, the protease inhibitor Kaletra, in combination with interferon, have modest activity against SARS-CoV and Middle East respiratory syndrome (MERS)-CoV 10-12. However, A recent research from Cao and colleagues suggested Kaletra alone had a limited role in COVID-19 treatment 13. Considering that coronaviruses can hijack the antiviral responses of type I interferon through structural and non-structural proteins, utilizing interferon could provide an effective treatment to target and eliminate SARS-CoV-214, 15. However, Channappavanar et al have demonstrated that the delayed interferon-I expression was detrimental in the context of SARS-CoV-1 infection in mice16. In addition, retrospective studies with interferon combined with ribavirin have not shown an obvious benefit in patients with MERS12, 17. Together, it is imperative to acknowledge that the therapeutic potential of Kaletra and interferon is still controversial in treatment for COVID-19 and begs for further investigation.
The purpose of this study was to evaluate the efficacy and safety of interferon alfa-2b and Kaletra plus interferon alfa-2b for SARS-CoV-2 infection in adult patients hospitalized with COVID-19.