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Expert Rev Anti Infect Ther
. 2020 Nov 13.
doi: 10.1080/14787210.2021.1848545. Online ahead of print.
Efficacy and safety of lopinavir/ritonavir in the treatment of COVID-19: A systematic review
Betsy Ann Joseph 1 , Mahmoud Dibas 2 , Kirk W Evanson 3 , Geeta Paranjape 3 , Charan Thej Reddy Vegivinti 4 , Pragadeesh Thamarai Selvan 4 , Kavitha Saravu 5 , Nitin Gupta 5 , Yashwitha Sai Pulakurthi 6 , Praneeth Reddy Keesari 6 , Sriram Varsha 7 , Spandana Chittajallu 8 , Natalie L Reierson 1 , Nick Mikoff 1 , Shelby Kamrowski 1 , Megan Schmidt 1 , Amber R Davis 3 , John M Pederson 3 , Hemant K Mishra 9 , Jillienne C Touchette 3 , Kevin M Kallmes 1
Affiliations
- PMID: 33187459
- DOI: 10.1080/14787210.2021.1848545
Abstract
Objectives: To systematically review the clinical literature reporting the use of Lopinavir/ritonavir (LPV/r) for the treatment of patients with COVID-19 to assess the efficacy of LPV/r for the treatment of Cornonavirus disease 19 (COVID-19). Methods: The authors systematically searched PubMed and MedRxiv databases for studies describing treatment of COVID-19 patients using LPV/r compared to other therapies. Articles were excluded if they were case reports, opinion editorials, preclinical studies, single-armed studies, not written in English, not relevant to the topic, or published before May 2020. The included outcomes were viral clearance as measured by reverse-transcription polymerase chain reaction (RT-PCR) negativity and/or improvement on chest computed tomography (CT), mortality, and adverse events (AEs). Results: Among 858 total studies, 16 studies met the inclusion criteria and were included in the qualitative review. These studies consisted of 3 randomized control trials, 3 open-label trials, and 10 observational studies. Most of these studies did not report positive clinical outcomes with LPV/r treatment. Conclusion: The systematic review revealed insufficient evidence of effectiveness and clinical benefit of LPV/r in the treatment of patients with COVID-19. Specifically, LPV/r does not appear to improve clinical outcome, mortality, time to RT-PCR negativity, or chest CT clearance in patients with COVID-19.
Keywords: SARS virus; antiviral agents; coronavirus; lopinavir/ritonavir; pneumonia; severe acute respiratory syndrome.