Coronavirus Disease 2019 Treatment: A Review of Early and Emerging Options

McCreary, Erin K; Pogue, Jason M

Most recently, Cao [37] et al reported the results of an openlabel randomized trial comparing LPV/r 400/100 mg twice daily (n = 99) to standard care (n = 100) for the treatment of COVID-19 pneumonia. The primary endpoint was defined as the time from randomization to an improvement of 2 points on a 7-category ordinal scale or discharge from the hospital. Secondary outcomes included 28-day mortality, time until discharge, and virologic response on repeat oropharyngeal swabs over the course of the study. The median time from symptom onset to randomization was 13 (interquartile range [IQR], 11-16) days, and this did not differ between the groups. There was no significant difference in time to clinical improvement (16 [IQR, [13] [14] [15] [16] [17] , −17.3% to 5.7%) between patients receiving LPV/r and standard care. When the 3 patients who died after randomization but before receiving LPV/r were removed, there remained no difference in mortality (16.7% vs 25.0%; absolute difference, −8.3 percentage points; 95% CI, −19.6 to 3.0). More important, there was no difference between treatment arms in reduction of viral loads over time between the 2 groups.