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Lopinavir/ritonavir and interferon combination therapy may help shorten the duration of viral shedding in patients with COVID-19: A retrospective study in two designated hospitals in Anhui, China.
Zuo, Yan; Liu, Yunlei; Zhong, Qi; Zhang, Ke; Xu, Yuanhong; Wang, Zhongxin.
  • Zuo Y; Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
  • Liu Y; Department of Clinical Laboratory, Second People's Hospital of Fuyang, Fuyang, Anhui Province, China.
  • Zhong Q; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
  • Zhang K; Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
  • Xu Y; Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
  • Wang Z; Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
J Med Virol ; 92(11): 2666-2674, 2020 11.
Article in English | MEDLINE | ID: covidwho-505537
ABSTRACT
Prolonged viral shedding may pose a threat to the control of coronavirus disease-2019 (COVID-19), and data on the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding are still limited, with the associated factors being unknown. All adult patients with laboratory-confirmed COVID-19 were included in this retrospective cross-sectional study in two designated hospitals during 21 January 2020 to 16 March 2020 in Anhui, China. In all patients, data on the duration of SARS-CoV-2 RNA shedding were analyzed by reviewing all RNA detection results during hospitalization. In addition, demographic, clinical, treatment, laboratory, and outcome data were also collected from electronic medical records. Factors associated with prolonged viral shedding were analyzed with the Cox proportional hazards model. Among 181 patients, the mean age was 44.3 ± 13.2 years, and 55.2% were male. The median duration of viral shedding from illness onset was 18.0 days (interquartile range [IQR], 15.0-24.0). Prolonged viral shedding was associated with longer hospital stays (P < .001) and higher medical costs (P < .001). The severity of COVID-19 had nothing to do with prolonged shedding. Moreover, the median time from onset to antiviral treatment initiation was 5.0 days (IQR, 3.0-7.0). Delayed antiviral treatment (hazard ratio [HR], 0.976; 95% confidence interval [CI], 0.962-0.990]) and lopinavir/ritonavir + interferon-α (IFN-α) combination therapy as the initial antiviral treatment (HR 1.649; 95% CI, 1.162-2.339) were independent factors associated with prolonged SARS-CoV-2 RNA shedding. SARS-CoV-2 showed prolonged viral shedding, causing increased hospital stays and medical costs. Early initiation of lopinavir/ritonavir + IFN-α combination therapy may help shorten the duration of SARS-CoV-2 shedding.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Interferons / Virus Shedding / Ritonavir / Lopinavir / COVID-19 Drug Treatment Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: J Med Virol Year: 2020 Document Type: Article Affiliation country: Jmv.26127

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Interferons / Virus Shedding / Ritonavir / Lopinavir / COVID-19 Drug Treatment Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: J Med Virol Year: 2020 Document Type: Article Affiliation country: Jmv.26127