Comparative efficacy of two broad-spectrum antiviral drugs universally used for the treatment of COVID-19 in children

Meskina E.R., Khadisova M.K., Tselipanova E.E., Galkina L.A.

Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia

Background: Data on the efficacy and safety of antiviral drugs in children with COVID-19 are limited and do not allow a definitive conclusion about the advantages of any drug.
Objective: Comparative evaluation of the efficacy of two antiviral drugs with different mechanisms of action in the treatment of COVID-19 in children: oral umifenovir (UMF) and (interferon) IFN for intranasal use.
Materials and methods: A retrospective analysis of 130 medical records of children aged 2 to 18 years with RT-PCR-confirmed COVID-19 who received inpatient treatment during 2020–2022, during the period of spread of the initial SARS-CoV-2 variants and early Omicron variants, was conducted. The study included children with non-severe COVID-19 (moderate form 65.4%, pneumonia 36%) without risk factors who received umifenovir (UMF, n=86) or intranasal recombinant alpha-2b interferon (IFN, n=44), discharged from the hospital with recovery and a control RT-PCR test for SARS-CoV-2.
Results: In mild COVID-19, the duration of weakness was shorter in those receiving UMF than in the IFN group (1.83±0.79 vs. 2.73±1.35 days, p=0.030; difference 0.9 days [95% CI: 0.2–1.6]), and in moderate COVID-19, the duration of rhinitis was shorter (4.8±1.67 vs. 7.5±1.64 days, respectively, p=0.009; difference 2.7 days [1.5–3.7]). The absence of dynamics of lung lesion volume on CT scans was rare: 1.2% [95% CI: 0.0–3.5] in the UMF group and 4.5% [0.12–8.89] in the IFN group, respectively (p>0.05). UMF reduced the risks of SARS-CoV-2 RNA re-isolation at the time of clinical recovery (days 6–9 of illness) by 19.0% [95% CI: 3.6–34.5]; OR 0.402 [0.199–0.810]; OR 0.310 [95% CI: 0.299–0.779] (12.8% versus 31.8%, respectively, p=0.010). There were no adverse events with the use of UMF and IFN.
Conclusion: The use of UMF for the treatment of non-severe COVID-19 in children has some clinical advantages compared to the intranasal form of IFN. UMF reduced the risks of lack of virological sanitation at the time of clinical recovery. It is advisable to conduct additional pediatric prospective studies to determine the therapeutic and antiviral potential in COVID-19 caused by new SARS-CoV2 variants.

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About the Authors

Elena R. Meskina, Dr. Sci. (Med.), Head of the Children’s Infectious Diseases Department, Professor at the Department of Children’s Diseases,
Faculty of Continuous Medical Education Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia;
meskinaelena@rambler.ru, ORCID: https://orcid.org/0000-0002-1960-6868, (corresponding author)
Marima K. Khadisova, Cand. Sci. (Med.), Senior Researcher, Children’s Infectious Diseases Department, Professor at the Department of Children’s Diseases, Faculty of Continuous Medical Education Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia; murzabekova.marina.1979@mail.ru, ORCID: https://orcid.org/0000-0001-8293-6643,
Elena E. Tselipanova, Cand. Sci. (Med.), Senior Researcher, Children’s Infectious Diseases Department, Professor at the Department of Children’s Diseases, Faculty of Continuous Medical Education Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia; elena-tselip@yandex.ru, ORCID: https://orcid.org/0000-0002-0586-8402
Lidiya A. Galkina, Cand. Sci. (Med.), Senior Researcher, Children’s Infectious Diseases Department, Professor at the Department of Children’s Diseases, Faculty of Continuous Medical Education Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia; lidiya140855@mail.ru, ORCID: https://orcid.org/0000-0002-0052-2867

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