ABSTRACT

Objectives: To systematically review the clinical literature reporting the use of Lopinavir/ritonavir (LPV/r) for the treatment of patients with Cornonavirus disease 19 (COVID-19) to assess the efficacy of LPV/r for the treatment of COVID-19.

Methods: The authors systematically searched PubMed and MedRxiv databases for studies describing treatment of COVID-19 patients using LPV/r compared to other therapies. Articles were excluded if they were case reports, opinion editorials, preclinical studies, single-armed studies, not written in English, not relevant to the topic, or published before May 2020. The included outcomes were viral clearance as measured by reverse-transcription polymerase chain reaction (RT-PCR) negativity and/or improvement on chest computed tomography (CT), mortality, and adverse events.

Results: Among 858 total studies, 16 studies met the inclusion criteria and were included in the qualitative review. These studies consisted of 3 randomized control trials, 3 open-label trials, and 10 observational studies. Most of these studies did not report positive clinical outcomes with LPV/r treatment.

Conclusion: The systematic review revealed insufficient evidence of effectiveness and clinical benefit of LPV/r in the treatment of COVID-19 patients. Specifically, LPV/r does not appear to improve clinical outcome, mortality, time to RT-PCR negativity, or chest CT clearance in patients with COVID-19.

摘要

目的：系统回顾报告使用洛匹那韦/利托那韦 (LPV/r) 治疗冠状病毒病 19 (COVID-19) 患者的临床文献，以评估 LPV/r 治疗 COVID-19 的疗效。

方法：作者系统地搜索了 PubMed 和 MedRxiv 数据库，以获取描述与其他疗法相比使用 LPV/r 治疗 COVID-19 患者的研究。如果文章是病例报告、评论社论、临床前研究、单臂研究、非英文撰写、与主题无关或在 2020 年 5 月之前发表，则将其排除在外。 纳入的结果是通过逆转录聚合酶测量的病毒清除率链反应 (RT-PCR) 阴性和/或改善胸部计算机断层扫描 (CT)、死亡率和不良事件。

结果：在858项研究中，16项研究符合纳入标准并被纳入定性评价。这些研究包括 3 项随机对照试验、3 项开放标签试验和 10 项观察性研究。大多数这些研究没有报告 LPV/r 治疗的积极临床结果。

结论：系统评价显示，LPV/r 治疗 COVID-19 患者的有效性和临床获益证据不足。具体而言，LPV/r 似乎不会改善 COVID-19 患者的临床结果、死亡率、RT-PCR 阴性时间或胸部 CT 清除率。