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Roshini Claire Anthony, 24 Apr 2020

The gap in overall life expectancy between people with HIV (PWH) and those without HIV has narrowed over time, particularly among optimally treated PWH. However, PWH still have fewer comorbidity-free years than those without HIV, according to a study presented at CROI 2020.

Is lopinavir-ritonavir effective against severe COVID-19?

05 Apr 2020

Treatment with lopinavir-ritonavir in addition to standard care appears to have no clear benefit in hospitalized adult patients with severe coronavirus disease (COVID-19), reveals a study.

A total of 199 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were randomly assigned to receive either lopinavir-ritonavir (400 mg and 100 mg, respectively; n=99) twice a day for 14 days, in addition to standard care, or standard care alone (n=100). Time to clinical improvement was the primary endpoint.

Time to clinical improvement was defined as “the time from randomization to either an improvement of two points on a seven-category ordinal scale or discharge from the hospital, whichever came first.”

The primary endpoint was not significantly different between lopinavir-ritonavir and standard care (hazard ratio [HR] for clinical improvement, 1.24, 95 percent confidence interval [CI], 0.90–1.72). Mortality at 28 days was also comparable between the two treatment groups (19.2 percent vs 25.0 percent; difference, –5.8 percent, 95 percent CI, –17.3 to 5.7).

For patients with detectable viral RNA at various time points, the proportion was similar between the lopinavir-ritonavir group and the standard-care group. Patients treated with lopinavir-ritonavir had a median time to clinical improvement that was 1 day shorter than that seen in those receiving standard care (HR, 1.39, 95 percent CI, 1.00–1.91).

Gastrointestinal adverse events occurred more frequently in the lopinavir-ritonavir group, while serious adverse events were more common in the standard-care group. Thirteen patients (13.8 percent) discontinued treatment with lopinavir-ritonavir early due to adverse events.

“Future trials in patients with severe illness may help to confirm or exclude the possibility of a treatment benefit,” the Investigators said.

SARS-CoV-2 causes the respiratory illness COVID-19. It was first detected in Wuhan, China, and eventually spread across the globe due to censorship by Chinese authorities and delayed institution of travel restrictions. Infections worldwide have now breached the 1 million mark, with more than 52,000 deaths, as of this writing.

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Most Read Articles
Roshini Claire Anthony, 24 Apr 2020

The gap in overall life expectancy between people with HIV (PWH) and those without HIV has narrowed over time, particularly among optimally treated PWH. However, PWH still have fewer comorbidity-free years than those without HIV, according to a study presented at CROI 2020.