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

J Infect. 2020 Jul;81(1):e1-e5. doi: 10.1016/j.jinf.2020.03.002. Epub 2020 Mar 11.

Abstract

Background: Corona 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.

Methods: In 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).

Results: We 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).

Conclusion: In patients with COVID-19, the apparent favorable clinical response with arbidol and LPV/r supports further LPV/r only.

Keywords: Antiviral intervention; Arbidol; Combination therapy; Corona Virus Disease 2019; Lopinavir/ritonavir.

MeSH terms

  • Administration, Oral
  • Adult
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • COVID-19
  • Cohort Studies
  • Coronavirus Infections / diagnostic imaging
  • Coronavirus Infections / drug therapy*
  • Drug Combinations
  • Drug Therapy, Combination
  • Female
  • Humans
  • Indoles / administration & dosage
  • Indoles / therapeutic use*
  • Lopinavir / administration & dosage
  • Lopinavir / therapeutic use*
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnostic imaging
  • Pneumonia, Viral / drug therapy*
  • Retrospective Studies
  • Ritonavir / administration & dosage
  • Ritonavir / therapeutic use*
  • Tomography, X-Ray Computed

Substances

  • Antiviral Agents
  • Drug Combinations
  • Indoles
  • lopinavir-ritonavir drug combination
  • Lopinavir
  • umifenovir
  • Ritonavir