Department of Infectious Diseases, the Fifth Affiliated Hospital, Sun Yat-sen University, 52 East Meihua Road, Zhuhai 519000, Guangdong Province, China.
Cancer Center, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province, China.
J Infect. 2020 Jul;81(1):e1-e5. doi: 10.1016/j.jinf.2020.03.002. Epub 2020 Mar 11.
Corona Virus Disease 2019 (COVID-19) due to the 2019 novel coronavirus (SARS-CoV-2) emerged in Wuhan city and rapidly spread throughout China. We aimed to compare arbidol and lopinavir/ritonavir(LPV/r) treatment for patients with COVID-19 with LPV/r only.
In this retrospective cohort study, we included adults (age≥18years) with laboratory-confirmed COVID-19 without Invasive ventilation, diagnosed between Jan 17, 2020, and Feb 13, 2020. Patients, diagnosed after Jan 17, 2020, were given oral arbidol and LPV/r in the combination group and oral LPV/r only in the monotherapy group for 5-21 days. The primary endpoint was a negative conversion rate of coronavirus from the date of COVID-19 diagnosis(day7, day14), and assessed whether the pneumonia was progressing or improving by chest CT (day7).
We analyzed 16 patients who received oral arbidol and LPV/r in the combination group and 17 who oral LPV/r only in the monotherapy group, and both initiated after diagnosis. Baseline clinical, laboratory, and chest CT characteristics were similar between groups. The SARS-CoV-2 could not be detected for 12(75%) of 16 patients' nasopharyngeal specimens in the combination group after seven days, compared with 6 (35%) of 17 in the monotherapy group (p < 0·05). After 14 days, 15 (94%) of 16 and 9 (52·9%) of 17, respectively, SARS-CoV-2 could not be detected (p < 0·05). The chest CT scans were improving for 11(69%) of 16 patients in the combination group after seven days, compared with 5(29%) of 17 in the monotherapy group (p < 0·05).
In patients with COVID-19, the apparent favorable clinical response with arbidol and LPV/r supports further LPV/r only.
2019 年新型冠状病毒（SARS-CoV-2）引发的 2019 年冠状病毒病（COVID-19）首先在中国武汉市出现，并迅速在中国蔓延。我们旨在比较利巴韦林和洛匹那韦/利托那韦（LPV/r）与仅 LPV/r 治疗 COVID-19 患者的效果。
在这项回顾性队列研究中，我们纳入了 2020 年 1 月 17 日至 2 月 13 日期间确诊、无有创通气的实验室确诊 COVID-19 的成年患者（年龄≥18 岁）。2020 年 1 月 17 日后确诊的患者，在联合组接受利巴韦林和 LPV/r 口服治疗，而在单药组仅接受 LPV/r 口服治疗，疗程为 5-21 天。主要终点是从 COVID-19 诊断之日起（第 7 天和第 14 天）冠状病毒的阴转率，并通过胸部 CT 评估肺炎是否进展或改善（第 7 天）。
我们分析了 16 名接受联合组利巴韦林和 LPV/r 口服治疗的患者和 17 名接受单药组 LPV/r 口服治疗的患者，两组均在确诊后开始治疗。两组患者的基线临床、实验室和胸部 CT 特征相似。联合组 16 例患者中有 12 例（75%）的鼻咽标本在第 7 天无法检测到 SARS-CoV-2，而单药组 17 例患者中仅有 6 例（35%）无法检测到（p<0.05）。第 14 天，分别有 15 例（94%）和 9 例（52.9%）患者无法检测到 SARS-CoV-2（p<0.05）。联合组 16 例患者中有 11 例（69%）的胸部 CT 扫描在第 7 天改善，而单药组 17 例患者中仅有 5 例（29%）改善（p<0.05）。
在 COVID-19 患者中，利巴韦林和 LPV/r 的明显有利临床反应支持仅使用 LPV/r。
