tetano
Editor, Senior Moderator
BMC Infect Dis
. 2021 Sep 14;21(1):952.
doi: 10.1186/s12879-021-06588-5.
Pneumonia-targeted lopinavir/ritonavir-based treatment for patients with COVID-19: an early-period retrospective single center observational study
Jongkyu Kim[SUP] #[/SUP][SUP] 1 [/SUP], Jiwoong Jung[SUP] #[/SUP][SUP] 2 [/SUP], Tae Ho Kim[SUP] 3 [/SUP], Naree Kang[SUP] 3 [/SUP], Hanzo Choi[SUP] 4 [/SUP], Dong Hyun Oh[SUP] 3 [/SUP], Mi Young Ahn[SUP] 3 [/SUP], Su Hyun Kim[SUP] 3 [/SUP], Chorom Hahm[SUP] 3 [/SUP], Young Kyong Lee[SUP] 5 [/SUP], Keunhong Park[SUP] 6 [/SUP], Kiho Hong[SUP] 7 [/SUP], Jae-Phil Choi[SUP] 8 [/SUP]
Affiliations
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.
Keywords: Coronavirus disease 2019 (COVID-19); Lopinavir/ritonavir; Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2; Treatment outcome; Virus shedding.
. 2021 Sep 14;21(1):952.
doi: 10.1186/s12879-021-06588-5.
Pneumonia-targeted lopinavir/ritonavir-based treatment for patients with COVID-19: an early-period retrospective single center observational study
Jongkyu Kim[SUP] #[/SUP][SUP] 1 [/SUP], Jiwoong Jung[SUP] #[/SUP][SUP] 2 [/SUP], Tae Ho Kim[SUP] 3 [/SUP], Naree Kang[SUP] 3 [/SUP], Hanzo Choi[SUP] 4 [/SUP], Dong Hyun Oh[SUP] 3 [/SUP], Mi Young Ahn[SUP] 3 [/SUP], Su Hyun Kim[SUP] 3 [/SUP], Chorom Hahm[SUP] 3 [/SUP], Young Kyong Lee[SUP] 5 [/SUP], Keunhong Park[SUP] 6 [/SUP], Kiho Hong[SUP] 7 [/SUP], Jae-Phil Choi[SUP] 8 [/SUP]
Affiliations
- PMID: 34521365
- DOI: 10.1186/s12879-021-06588-5
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.
Keywords: Coronavirus disease 2019 (COVID-19); Lopinavir/ritonavir; Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2; Treatment outcome; Virus shedding.