法匹拉韦与洛匹那韦/利托那韦联合用药在COVID-19治疗中的比较。
The comparison of favipiravir and lopinavir/ritonavir combination in COVID-19 treatment.
作者信息
Çınarka Halit, Günlüoğlu Gülşah, Çörtük Mustafa, Yurt Sibel, Kıyık Murat, Koşar Filiz, Tanrıverdi Elif, Arslan Melih Akay, Baydili Kürşad Nuri, Koç Aysu Sinem, Altın Sedat, Çetinkaya Erdoğan
机构信息
Department of Pulmonology, University of Health Sciences Yedikule Pulmonary Diseases and Thoracic Surgery Education and Research Hospital, İstanbul, Turkey
Department of Biostatistics, Faculty of Medicine, University of Health Sciences, İstanbul, Turkey
出版信息
Turk J Med Sci. 2021 Aug 30;51(4):1624-1630. doi: 10.3906/sag-2012-189.
BACKGROUND/AIM: SARS-CoV-2, a ribonucleic acid coronavirus, rapidly spread worldwide within a short timeframe. Although different antiviral, antiinflammatory, and immunomodulatory drugs are used, current evidence is insufficient as to which drug is more efficient. Our study compared favipiravir and lopinavir/ritonavir (LPV/RTV) therapies in inpatient care for coronavirus disease 2019 (COVID-19) pneumonia.
MATERIALS AND METHODS
Demographic data, test results, treatments, and latest status of patients receiving inpatient COVID-19 pneumonia therapy were recorded. The initial favipiravir and LPV/RTV receiving groups were compared regarding the need for intensive care units (ICU) and mortality. Logistic regression analysis was performed by including variables showing significant differences as a result of paired comparisons into the model.
RESULTS
Of the 204 patients with COVID-19 pneumonia, 59 (28.9%), 131 (64.2%), and 14 were administered LPV/RTV, favipiravir, and favipiravir with LPV/RTV, respectively. No difference was found in age, sex, presence of comorbidity, and tocilizumab, systemic corticosteroid, and plasma therapy use between patients administered with these three different treatment regimens. The mean mortality age of the patients was 71 ± 14.3 years, which was substantially greater than that of the survivors (54.2 ± 15.5 years). Compared with patients administered with LPV/RTV, ICU admission and mortality rates were lower in patients administered with favipiravir. CK-MB, AST, CRP, LDH, and creatinine levels were higher, whereas lymphocyte counts were lower in patients who died. Age, AST, CRP, LDH, and neutrophil counts were higher in patients needing ICU, and eosinophil and lymphocyte counts were significantly lower. Logistic regression analysis showed that favipiravir use independently decreased mortality (p = 0.006).
CONCLUSION
The use of favipiravir was more effective than LPV/RTV in reducing mortality in hospitalized patients with COVID-19.
背景/目的：严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是一种核糖核酸冠状病毒，在短时间内迅速在全球传播。尽管使用了不同的抗病毒、抗炎和免疫调节药物，但目前关于哪种药物更有效的证据不足。我们的研究比较了法匹拉韦和洛匹那韦/利托那韦（LPV/RTV）疗法在2019冠状病毒病（COVID-19）肺炎住院治疗中的效果。
材料与方法
记录接受COVID-19肺炎住院治疗患者的人口统计学数据、检测结果、治疗情况和最新状态。比较初始接受法匹拉韦和LPV/RTV治疗的两组患者进入重症监护病房（ICU）的需求和死亡率。将配对比较结果显示有显著差异的变量纳入模型进行逻辑回归分析。
结果
在204例COVID-19肺炎患者中，分别有59例（28.9%）、131例（64.2%）和14例接受了LPV/RTV、法匹拉韦以及法匹拉韦联合LPV/RTV治疗。接受这三种不同治疗方案的患者在年龄、性别、合并症情况以及托珠单抗、全身用糖皮质激素和血浆治疗的使用方面均未发现差异。患者的平均死亡年龄为71±14.3岁，显著高于幸存者（54.2±15.5岁）。与接受LPV/RTV治疗的患者相比，接受法匹拉韦治疗的患者进入ICU的比例和死亡率更低。死亡患者的肌酸激酶同工酶（CK-MB）、天门冬氨酸氨基转移酶（AST）、C反应蛋白（CRP）、乳酸脱氢酶（LDH）和肌酐水平较高，而淋巴细胞计数较低。需要进入ICU的患者年龄、AST、CRP、LDH和中性粒细胞计数较高，嗜酸性粒细胞和淋巴细胞计数显著较低。逻辑回归分析显示，使用法匹拉韦可独立降低死亡率（p = 0.006）。
结论
在降低COVID-19住院患者死亡率方面，法匹拉韦的使用比LPV/RTV更有效。
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