Predictive association of C3435T genetic polymorphism with the efficacy or safety of lopinavir and ritonavir in COVID-19 patients.

Lopinavir and ritonavir are substrates of permeability glycoprotein encoded by  The efficacy and safety of these drugs is unknown in COVID-19 patients affected by genetic variability. Patients carrying one or two copies of the C3435T were predictively considered as risk phenotypes. It was predicted that risk phenotypes due to carrying either one or two copies of C3435T were highly prevalent in Europe (76.8%; 95% CI: 75-78), followed by America (67%; 95% CI: 65-69), Asia (63.5%; 95% CI: 62-65) and Africa (41.4%; 95% CI: 37-46), respectively. It is hypothesized that a considerable proportion of COVID-19 patients treated with lopinavir/ritonavir inheriting C3435T genetic polymorphism may be predisposed to either therapeutic failure or toxicity.