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Efficacy and Safety of Lopinavir/Ritonavir for Treatment of COVID-19: A Systematic Review and Meta-Analysis.
Alhumaid, Saad; Mutair, Abbas Al; Alawi, Zainab Al; Alhmeed, Naif; Zaidi, Abdul Rehman Zia; Tobaiqy, Mansour.
  • Alhumaid S; Administration of Pharmaceutical Care, Ministry of Health, Al-Ahsa 31982, Saudi Arabia.
  • Mutair AA; Research Center, Almoosa Specialist Hospital, Al-Ahsa 31982, Saudi Arabia.
  • Alawi ZA; Department of Pediatrics, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia.
  • Alhmeed N; Administration of Supply and Shared Services, Ministry of Health, Riyadh 11461, Saudi Arabia.
  • Zaidi ARZ; Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh 11461, Saudi Arabia.
  • Tobaiqy M; Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah 21442, Saudi Arabia.
Trop Med Infect Dis ; 5(4)2020 Nov 28.
Article in English | MEDLINE | ID: covidwho-948871
ABSTRACT
(Background) Lopinavir-ritonavir (LPV/RTV) is a human immunodeficiency virus (HIV) antiviral combination that has been considered for the treatment of COVID-19 disease. (Aim) This systematic review aimed to assess the efficacy and safety of LPV/RTV in COVID-19 patients in the published research. (Methods) A protocol was developed based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement. Articles were selected for review from 8 electronic databases. This review evaluated the effects of LPV/RTV alone or in combination with standard care ± interferons/antiviral treatments compared to other therapies, regarding duration of hospital stay, risk of progressing to invasive mechanical, time to virological cure and body temperature normalization, cough relief, radiological progression, mortality and safety. (Results) A consensus was reached to select 32 articles for full-text screening; only 14 articles comprising 9036 patients were included in this study; and eight of these were included for meta-analysis. Most of these studies did not report positive clinical outcomes with LPV/RTV treatment. In terms of virological cure, three studies reported less time in days to achieve a virological cure for LPV/RTV arm relative to no antiviral treatment (-0.81 day; 95% confidence interval (CI), -4.44 to 2.81; p = 0.007, I2 = 80%). However, the overall effect was not significant (p = 0.66). When comparing the LPV/RTV arm to umifenovir arm, a favorable affect was observed for umifenovir arm, but not statically significant (p = 0.09). In terms of time to body normalization and cough relief, no favorable effects of LPV/RTV versus umifenovir were observed. The largest trials (RECOVERY and SOLIDARITY) have shown that LPV/RTV failed to reduce mortality, initiation of invasive mechanical ventilation or hospitalization duration. Adverse events were reported most frequently for LPV/RTV (n = 84) relative to other antivirals and no antiviral treatments. (Conclusions) This review did not reveal any significant advantage in efficacy of LPV/RTV for the treatment of COVID-19 over standard care, no antivirals or other antiviral treatments. This result might not reflect the actual evidence.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Year: 2020 Document Type: Article Affiliation country: Tropicalmed5040180

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Year: 2020 Document Type: Article Affiliation country: Tropicalmed5040180