tetano
Editor, Senior Moderator
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[SUP] 1 [/SUP], Mahmoud Dibas[SUP] 2 [/SUP], Kirk W Evanson[SUP] 3 [/SUP], Geeta Paranjape[SUP] 3 [/SUP], Charan Thej Reddy Vegivinti[SUP] 4 [/SUP], Pragadeesh Thamarai Selvan[SUP] 4 [/SUP], Kavitha Saravu[SUP] 5 [/SUP], Nitin Gupta[SUP] 5 [/SUP], Yashwitha Sai Pulakurthi[SUP] 6 [/SUP], Praneeth Reddy Keesari[SUP] 6 [/SUP], Sriram Varsha[SUP] 7 [/SUP], Spandana Chittajallu[SUP] 8 [/SUP], Natalie L Reierson[SUP] 1 [/SUP], Nick Mikoff[SUP] 1 [/SUP], Shelby Kamrowski[SUP] 1 [/SUP], Megan Schmidt[SUP] 1 [/SUP], Amber R Davis[SUP] 3 [/SUP], John M Pederson[SUP] 3 [/SUP], Hemant K Mishra[SUP] 9 [/SUP], Jillienne C Touchette[SUP] 3 [/SUP], Kevin M Kallmes[SUP] 1 [/SUP]
Affiliations
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.
. 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[SUP] 1 [/SUP], Mahmoud Dibas[SUP] 2 [/SUP], Kirk W Evanson[SUP] 3 [/SUP], Geeta Paranjape[SUP] 3 [/SUP], Charan Thej Reddy Vegivinti[SUP] 4 [/SUP], Pragadeesh Thamarai Selvan[SUP] 4 [/SUP], Kavitha Saravu[SUP] 5 [/SUP], Nitin Gupta[SUP] 5 [/SUP], Yashwitha Sai Pulakurthi[SUP] 6 [/SUP], Praneeth Reddy Keesari[SUP] 6 [/SUP], Sriram Varsha[SUP] 7 [/SUP], Spandana Chittajallu[SUP] 8 [/SUP], Natalie L Reierson[SUP] 1 [/SUP], Nick Mikoff[SUP] 1 [/SUP], Shelby Kamrowski[SUP] 1 [/SUP], Megan Schmidt[SUP] 1 [/SUP], Amber R Davis[SUP] 3 [/SUP], John M Pederson[SUP] 3 [/SUP], Hemant K Mishra[SUP] 9 [/SUP], Jillienne C Touchette[SUP] 3 [/SUP], Kevin M Kallmes[SUP] 1 [/SUP]
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.