Author: Giacomelli, Andrea; Pagani, Gabriele; Ridolfo, Anna Lisa; Oreni, Letizia; Conti, Federico; Pezzati, Laura; Bradanini, Lucia; Casalini, Giacomo; Bassoli, Cinzia; Morena, Valentina; Passerini, Simone; Rizzardini, Giuliano; Cogliati, Chiara; Ceriani, Elisa; Colombo, Riccardo; Rusconi, Stefano; Gervasoni, Cristina; Cattaneo, Dario; Antinori, Spinello; Galli, Massimo
Title: Early administration of lopinavir/ritonavir plus hydroxychloroquine does not alter the clinical course of SARSâ€CoVâ€2 infection: a retrospective cohort study Cord-id: s70oxjui Document date: 2020_8_10
ID: s70oxjui
Snippet: BACKGROUND: As it has been shown that lopinavir (LPV) and hydroxychloroquine (HCQ) have in vitro activity against coronaviruses, they were used to treat COVIDâ€19 during the first wave of the epidemic in Lombardy, Italy. METHODS: To compare the rate of clinical improvement between those who started LPV/ritonavir (LPV/r)+HCQ within five days of symptom onset (early treatment, ET) and those who started later (delayed treatment, DT). This was a retrospective intentâ€toâ€treat analysis of the hos
Document: BACKGROUND: As it has been shown that lopinavir (LPV) and hydroxychloroquine (HCQ) have in vitro activity against coronaviruses, they were used to treat COVIDâ€19 during the first wave of the epidemic in Lombardy, Italy. METHODS: To compare the rate of clinical improvement between those who started LPV/ritonavir (LPV/r)+HCQ within five days of symptom onset (early treatment, ET) and those who started later (delayed treatment, DT). This was a retrospective intentâ€toâ€treat analysis of the hospitalized patients who started LPV/r+HCQ between 21 February and 20 March 2020. The association between the timing of treatment and the probability of 30â€day mortality was assessed using uni†and multivariable logistic models. RESULTS: The study involved 172 patients: 43 (25%) in the ET and 129 (75%) in the DT group. The rate of clinical improvement increased over time to 73.3% on day 30, without any significant difference between the two groups (Gray's test P=0.213). After adjusting for potentially relevant clinical variables, there was no significant association between the timing of the start of treatment and the probability of 30â€day mortality (adjusted odds ratio [aOR] ET vs DT=1.45, 95% confidence interval 0.50â€4.19). Eight percent of the patients discontinued the treatment because of severe gastrointestinal disorders attributable to LPV/r. CONCLUSION: The timing of the start of LPV/r+HCQ treatment does not seem to affect the clinical course of hospitalised patients with COVIDâ€19. Together with the severe adverse events attributable to LPV/r, this raises concerns about the benefit of using this combination to treat COVIDâ€19. This article is protected by copyright. All rights reserved.
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