Associations of clinical characteristics and antiviral drugs with viral RNA clearance in patients with COVID-19 in Guangzhou, China: a retrospective cohort study

Xudan Chen; Yang Zhang; Baoyi Zhu; Jianwen Zeng; Wenxin Hong; Xi He; Jingfeng Chen; Haipeng Zheng; Shuang Qiu; Ying Deng; Juliana Chan; Jian Wang

There was no specific guideline on indication of use of antiviral drugs. We compared the effects of different antiviral drug combinations (chloroquine, oseltamivir, arbidol, and lopinavir/ritonavir) on viral RNA clearance. As shown in Table 4 , 121 (43.2%) patients did not receive any antiviral drugs, and the median duration was 11 days (IQR: 7-15) from illness onset, and 6 days (IQR: 4-9) from hospital admission to viral RNA clearance. The use of antiviral drugs, as monotherapy or in combination, was not associated with improved clearance of viral RNA compared to those did not receive antiviral drugs. Patients treated with lopinavir/ritonavir, a combination therapy for treating HIV infection, tended to have delayed viral RNA clearance, even after controlling for age, disease severity, time lag from illness onset to hospital admission, temperature, and corticosteroid use. The combined use of two antiviral agents was also associated with delayed clearance of viral RNA after adjusting for confounders. The analysis focusing on patients with moderate illness yielded similar results (Table 4 and Figure 1 ).