Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Virological and Clinical Outcomes in Adults Treated with Ribavirin Aerosol for COVID-19 Pneumonia

Emanuela Messina
,
Giulia Morsica
* ORCID logo ,
Sabrina Bagaglio
,
Laura Galli
,
Riccardo Lolatto
,
Michela Sampaolo
,
Maxime Barakat
,
Robert J Israel
,
Antonella Castagna
,
Nicola Clementi
Version 1 : Received: 7 July 2023 / Approved: 10 July 2023 / Online: 10 July 2023 (10:16:20 CEST)

How to cite: Messina, E.; Morsica, G.; Bagaglio, S.; Galli, L.; Lolatto, R.; Sampaolo, M.; Barakat, M.; Israel, R.J.; Castagna, A.; Clementi, N. Virological and Clinical Outcomes in Adults Treated with Ribavirin Aerosol for COVID-19 Pneumonia. Preprints 2023, 2023070601. https://doi.org/10.20944/preprints202307.0601.v1 Messina, E.; Morsica, G.; Bagaglio, S.; Galli, L.; Lolatto, R.; Sampaolo, M.; Barakat, M.; Israel, R.J.; Castagna, A.; Clementi, N. Virological and Clinical Outcomes in Adults Treated with Ribavirin Aerosol for COVID-19 Pneumonia. Preprints 2023, 2023070601. https://doi.org/10.20944/preprints202307.0601.v1

Abstract

The emergence of new SARSCoV-2 variants can affect vaccine efficacy, laboratory diagnosis and therapies already available, triggering interest in the search for antiviral agents for SARSCoV-2 infections. Ribavirin (RBV) is a broad-spectrum antiviral with demonstrated in vitro activity against multiple viruses, including SARSCoV-2. Methods. This retrospective study evaluated the dynamic and viral clearance of SARSCoV-2 in hospitalized adult participants (PTs) with COVID-19 pneumonia who received RBV aerosol within a compassionate use study. Was also assessed the impact of RBV on the clinical outcome and the mutational profile of SARSCoV-2. Results. The median RNA values measured in nine PTs included in the study de-creased from baseline to discharge (at BL, threshold cycle (Ct)=22.4, IQR 19.84-5.07; at discharge, Ct=27.92, IQR 26.43-36.11). Seven/9 PTs experienced a clinical improvement, while two PTs deceased during hos-pitalization. In PTs with a favorable outcome the virus clearance rate at discharge was 28.6%. The cumulative clearance rate was 71.4% within day 14th from discharge. A mutational pattern after RBV was detected in 3/5 PTs in whom was available whole genome sequencing. Conclusions. RBV may limit SARSCOV-2 replication resulting in a favorable clinical outcome. Ribavirin may also contribute to the mutational spectrum of SARSCoV-2.

Keywords

COVID-19; pneumonia; ribavirin aerosol; treatment; outcome; viral load; whole genome sequencing

Subject

Medicine and Pharmacology, Clinical Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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