Arbidol combined with LPV/r versus LPV/r alone against Corona Virus Disease 2019: A retrospective cohort study

Abstract

Highlights Patients were given oral arbidol and LPV/r in the combination group and oral LPV/r only in the monotherapy group for 5-21 days  Our study shows that oral arbidol and LPV/r in the combination group is associated with a significant elevated negative conversion rate of coronavirus' test in 7-day and 14-day, compared with LPV/r only in the monotherapy group. Combination therapy is associated with a significantly improved the chest CT scans in 7-day. We suppose that reducing the viral load as soon as possible could benefit the delay of the progression of lung lesions. Abstract BackgroundCorona Virus Disease 2019 (COVID-19) due to the 2019 novel coronavirus (SARS-CoV-2) emerged in Wuhan city and rapidly spread throughout China. We aimed to compare arbidol and lopinavir/ritonavir(LPV/r) treatment for patients with COVID-19 with LPV/r only. MethodsIn this retrospective cohort study, we included adults (age≥18years) with laboratory-confirmed COVID-19 without Invasive ventilation, diagnosed between Jan 17, 2020, and Feb 13, 2020. Patients, diagnosed after Jan 17, 2020, were given oral arbidol and LPV/r in the combination group and oral LPV/r only in the monotherapy group for 5-21 days. The primary endpoint was a negative conversion rate of coronavirus from the date of COVID-19 diagnosis(day7, day14), and assessed whether the pneumonia was progressing or improving by chest CT (day7). ResultsWe analyzed 16 patients who received oral arbidol and LPV/r in the combination group and 17 who oral LPV/r only in the monotherapy group, and both initiated after diagnosis. Baseline clinical, laboratory, and chest CT characteristics were similar between groups. The SARS-CoV-2 could not be detected for 12(75%) of 16 patients' nasopharyngeal specimens in the combination group after seven days, compared with 6 (35%) of 17 in the monotherapy group (p<0·05). After 14 days, 15 (94%) of 16 and 9 (52·9%) of 17, respectively, SARS-CoV-2 could not be detected (p<0·05). The chest CT scans were improving for 11(69%) of 16 patients in the combination group after seven days, compared with 5(29%) of 17 in the monotherapy group (p<0·05). ConclusionIn patients with COVID-19, the apparent favorable clinical response with arbidol and LPV/r supports further LPV/r only.

Molecular Investigation of SARS–CoV-2 Proteins and Their Interactions with Antiviral Drugs

“…It is worth mentioning that several other groups are working on antiviral-based strategies to fight the new, big threat represented by SARS-CoV2; in some cases, patients were treated with some of the molecules chosen for our studies, i.e., Ritonavir, Lopinavir, Umifenovir [27,[40][41][42]: these data strongly support and corroborate the results of our work.…”

COVID-19 Pandemic: an Overview of epidemiology, pathogenesis, Diagnostics and Potential Vaccines and Therapeutics

“…This is maybe important as earlier viral clearance is associated with more prevention of severe lung lesions. Indeed, the patients' CT imaging at day 7 was significantly better in a combination group compared with control (69 vs 29%, respectively) [93]. Current ongoing clinical trials are further investigating the role of arbidol in the management of SARS-CoV-2 pneumonia in different combinations, including NCT04260594 and NCT04286503 [94].…”

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

“…The use of antiviral drugs approved for other conditions is largely empirical in these patients. Some antiviral drugs, such as chloroquine, arbidol, and lopinavir/ritonavir, have been investigated in small-scale studies and are recommended as options of antiviral regimens in China and some countries [11,[13][14][15][16][17]. However, the efficacy of these antiviral drugs on the SARS-CoV-2 RNA clearance remains largely unknown.…”