Pirfenidone As Potential Therapeutic Intervention for Coronavirus
Disease-19 (COVID-19)
Abstract
Background: Coronavirus disease 2019 (COVID-19) is a pandemic with no
specific drugs and high fatality. The most urgent need is to find
effective treatments. We sought to determine whether pirfenidone
treatment might reduce the death risk of COVID-19 patients. Methods:
Clinically confirmed COVID-19 cases at Tongji Hospital, Wuhan, China
from January 29, 2020 and April 27, 2020 were identified from electronic
medical records. Information on their demographics, history of
coexisting diseases, and therapies during hospitalization were
extracted. Based on whether taking pirfenidone during hospitalization,
patients were categorized into non-pirfenidone group and pirfenidone
group. The patients were further matched using propensity score
analysis. Results: In this retrospective study, about 59 patients were
treated by pirfenidone during hospitalization and 59 patients with
non-pirfenidone were matched. Compared with patients without pirfenidone
therapy, patients with pirfenidone therapy showed a better clinical
outcome and a decreased mortality (1.7% [1/59] vs. 32.2%
[19/59]; p<0.001). In terms of chest computed tomography
(CT) images, the ground-glass opacity (GGO)/consolidation signs were
obviously absorbed in the pirfenidone treated patients before discharge
compared with patients on admission. Moreover, the level of interleukin
(IL)-6 and IL-2 receptor were reduced on day 3 after pirfenidone
treatment. Moreover, there was a trend that patients with pirfenidone
therapy had lower levels of IL-1β, combined with lower hs-CRP,
lymphocytes, LDH and NT-proBNP on day 3 after pirfenidone
administration. In addition, patients with pirfenidone therapy had
higher serum albumin level on day 3 after pirfenidone
administration.Conclusion: COVID-19 patients could benefit from the
pirfenidone therapy during hospitalization.