Ribavirin is an inosine monophosphate dehydrogenase inhibitor with demonstrated activity against coronaviruses, including SARS-CoV-2. Five hospitalized patients with COVID-19 (confirmed by positive tests for SARS-CoV-2) received treatment with ribavirin for inhalation solution (ribavirin aerosol) as part of a compassionate use program. Patients included four men and one woman, with an age range of 29–72 years. Patients were managed according to international and Italian treatment guidelines for COVID-19. In addition, therapy with ribavirin aerosol 100 mg/mL was administered for 30 min twice daily for 6 days (i.e., 12 doses) in all patients. In order to address concerns about a possible increase in viral dispersal with the use of a nebulizer, healthcare providers remained outside the patient room during ribavirin aerosol administration. Pretreatment chest computed tomography (CT) scans showed pseudonodular areas of parenchymal thickening in the upper right lobe with associated ground glass opacities, multiple areas of parenchymal consolidation in both lower lobes with associated ground glass opacities, bilateral parenchymal thickening and multiple associated ground glass areas, or focal ground glass areas in the upper lobes bilaterally, which were almost completely resolved (three patients) or moderately cleared (one patient) on imaging at the end of ribavirin treatment. For a fifth patient, CT scans showed a stable pulmonary picture at the end of ribavirin treatment. No adverse reactions to ribavirin treatment were observed in any of the five patients. All patients recovered fully, and nasopharyngeal swabs obtained after hospital discharge tested negative for SARS-CoV-2. Ribavirin aerosol appears to be efficacious in the treatment of patients with COVID-19. A controlled trial of ribavirin aerosol is ongoing and will provide additional data across a broader patient population.

利巴韦林是一种肌苷单磷酸脱氢酶抑制剂，已证明对冠状病毒（包括 SARS-CoV-2）具有活性。作为同情使用计划的一部分，五名 COVID-19 住院患者（经 SARS-CoV-2 阳性检测证实）接受了利巴韦林吸入溶液（利巴韦林气雾剂）治疗。患者包括四男一女，年龄范围为 29-72 岁。根据国际和意大利 COVID-19 治疗指南对患者进行管理。此外，所有患者均使用 100 mg/mL 利巴韦林气雾剂进行治疗，每次 30 分钟，每天两次，共 6 天（即 12 剂）。为了解决使用雾化器可能增加病毒传播的担忧，在利巴韦林气雾剂给药期间，医疗保健提供者留在病房外。治疗前胸部计算机断层扫描 (CT) 扫描显示右上叶实质增厚的假性结节区域伴相关磨玻璃影，双下叶多处实质实变区域伴磨玻璃影，双侧实质增厚和多处相关磨玻璃影区域，或双侧上叶的局灶性磨玻璃区域，在利巴韦林治疗结束时在成像上几乎完全消退（三名患者）或中度清除（一名患者）。对于第五名患者，在利巴韦林治疗结束时，CT 扫描显示肺部图像稳定。在五名患者中的任何一位中均未观察到对利巴韦林治疗的不良反应。所有患者均完全康复，出院后获得的鼻咽拭子检测结果为 SARS-CoV-2 阴性。利巴韦林气雾剂似乎对治疗 COVID-19 患者有效。一项关于利巴韦林气雾剂的对照试验正在进行中，将在更广泛的患者群体中提供更多数据。