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Comparing the effectiveness of Atazanavir/Ritonavir/Dolutegravir/Hydroxychloroquine and Lopinavir/Ritonavir/Hydroxychloroquine treatment regimens in COVID-19 patients.
Kalantari, Saeed; Fard, Soheil R; Maleki, Donya; Taher, Mahshid T; Yassin, Zeynab; Alimohamadi, Yousef; Minaeian, Sara.
  • Kalantari S; Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
  • Fard SR; Department of Infectious Diseases, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • Maleki D; Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
  • Taher MT; Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
  • Yassin Z; Department of Infectious Diseases, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • Alimohamadi Y; Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
  • Minaeian S; Department of Infectious Diseases, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
J Med Virol ; 93(12): 6557-6565, 2021 12.
Article in English | MEDLINE | ID: covidwho-1544300
ABSTRACT
The purpose of this study was to compare the effectiveness of Atazanavir/Ritonavir/Dolutegravir/Hydroxychloroquine and Lopinavir/Ritonavir/Hydroxychloroquine treatment regimens in COVID-19 patients based on clinical and laboratory parameters. We prospectively evaluated the clinical and laboratory outcomes of 62 moderate to severe COVID-19 patients during a 10-day treatment plan. Patients were randomly assigned to either KH (receiving Lopinavir/Ritonavir [Kaletra] plus Hydroxychloroquine) or ADH (receiving Atazanavir/Ritonavir, Dolutegravir, and Hydroxychloroquine) groups. During this period, clinical and laboratory parameters and outcomes such as intensive care unit (ICU) admission or mortality rate were recorded. Compared to the KH group, after the treatment period, patients in the ADH group had higher activated partial thromboplastin time (aPTT) (12, [95% confidence interval [CI] 6.97, 17.06), p = <0.01), international normalized ratio (INR) (0.17, [95% CI 0.07, 0.27), p = <0.01) and lower C-reactive protein (CRP) (-14.29, (95% CI -26.87, -1.71), p = 0.03) and potassium (-0.53, (95% CI -1.03, -0.03), p = 0.04) values. Moreover, a higher number of patients in the KH group needed invasive ventilation (6 (20%) vs. 1 (3.1%), p = 0.05) and antibiotic administration (27 (90%) vs. 21(65.6), p = 0.02) during hospitalization while patients in the ADH group needed more corticosteroid administration (9 (28.1%) vs. 2 (6.7%), p = 0.03). There was no difference in mortality rate, ICU admission rate, and hospitalization period between the study groups. Our results suggest that the Atazanavir/Dolutegravir treatment regimen may result in a less severe disease course compared to the Lopinavir/Ritonavir treatment regimen and can be considered as an alternative treatment option beside standard care. However, to confirm our results, larger-scale studies are recommended.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Oxazines / Piperazines / Pyridones / Ritonavir / Lopinavir / Atazanavir Sulfate / COVID-19 Drug Treatment / Heterocyclic Compounds, 3-Ring / Hydroxychloroquine Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male / Middle aged Language: English Journal: J Med Virol Year: 2021 Document Type: Article Affiliation country: Jmv.27195

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Oxazines / Piperazines / Pyridones / Ritonavir / Lopinavir / Atazanavir Sulfate / COVID-19 Drug Treatment / Heterocyclic Compounds, 3-Ring / Hydroxychloroquine Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male / Middle aged Language: English Journal: J Med Virol Year: 2021 Document Type: Article Affiliation country: Jmv.27195