Pneumonia-targeted lopinavir/ritonavir-based treatment for patients with COVID-19: an early-period retrospective single center observational study.

Abstract

BACKGROUND:

Robust evidenced treatment strategy for Coronavirus disease 2019 (COVID-19) has not been established yet. Early, targeted, comprehensive management approach can be essential.

METHODS:

A lopinavir/ritonavir (LPV/r)-based antiviral treatment was administered to the patients with computed tomography (CT)-documented pneumonia. Medical records of patients with COVID-19, previously discharged or hospitalized for ≥ 21 days at the Seoul Medical Center from January 29 to April 15, 2020 were reviewed to analyze clinical and virological outcomes. Patients were divided into two groups (PCR-Negative conversion group vs. Non-negative conversion group and requiring oxygen group vs. Non-requiring oxygen group).

RESULTS:

In total, 136 patients with a mean age of 41.8 ± 18.2 years were included with median 3-day delay of hospitalization after illness. Thirteen (9.56%) were initially asymptomatic, and 5 (3.67%) were persistently asymptomatic. Eighty-five (62.5%) had CT-documented pneumonia, 94% of whom received LPV/r treatments. A total of 53 patients (38.97%) had negative polymerase chain reaction (PCR) results within 28 days. Eight (9.4%) out of 85 pneumonic patients received oxygen supplementation. Patients with initial lower respiratory symptoms showed significant delay in PCR negative conversion (> 28 days) (odds ratio [OR] 0.166; 95% confidence interval [CI] 0.067-0.477; P < 0.001). However, antiviral treatment for pneumonic patients was significantly related with early conversion within 28 days (OR 3.049; 95% CI 1.128-8.243; P = 0.028). Increasing age increased the likelihood of oxygen supplementation requirement in the pneumonic patient group (OR 1.108; 95% CI 1.021-1.202; P = 0.014).

CONCLUSIONS:

Early, pneumonia targeted LPV/r-based antiviral therapy resulted in a significantly higher probability of negative conversion of PCR within 28 days compared to symptomatic treatment.

• Authors: Jongkyu Kim, Jiwoong Jung, Tae Ho Kim, Naree Kang, Hanzo Choi, Dong Hyun Oh, Mi Young Ahn, Su Hyun Kim, Chorom Hahm, Young Kyong Lee, Keunhong Park, Kiho Hong, Jae-Phil Choi
• Journal: BMC infectious diseases (BMC Infect Dis) Vol. 21 Issue 1 Pg. 952 (Sep 14 2021) ISSN: 1471-2334 [Electronic] England
• PMID: 34521365 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2021. The Author(s).

Chemical References

• Antiviral Agents
• Drug Combinations
• Lopinavir
• Ritonavir

Topics

• Antiviral Agents (therapeutic use)
• Drug Combinations
• Humans
• Infant, Newborn
• Lopinavir (therapeutic use)
• Pneumonia (drug therapy)
• Retrospective Studies
• Ritonavir (therapeutic use)
• SARS-CoV-2
• COVID-19 Drug Treatment