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Hydroxychloroquine versus lopinavir/ritonavir in severe COVID-19 patients: Results from a real-life patient cohort
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a high mortality. To date no trial comparing hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/RTV) has been performed. METHODS: Hospitalized patients ≥18 years old with severe coronavirus disea...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Vienna
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416584/ https://www.ncbi.nlm.nih.gov/pubmed/32776298 http://dx.doi.org/10.1007/s00508-020-01720-y |
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author | Karolyi, Mario Pawelka, Erich Mader, Theresa Omid, Sara Kelani, Hasan Ely, Sarah Jilma, Bernd Baumgartner, Sebastian Laferl, Hermann Ott, Clemens Traugott, Marianna Turner, Michael Seitz, Tamara Wenisch, Christoph Zoufaly, Alexander |
author_facet | Karolyi, Mario Pawelka, Erich Mader, Theresa Omid, Sara Kelani, Hasan Ely, Sarah Jilma, Bernd Baumgartner, Sebastian Laferl, Hermann Ott, Clemens Traugott, Marianna Turner, Michael Seitz, Tamara Wenisch, Christoph Zoufaly, Alexander |
author_sort | Karolyi, Mario |
collection | PubMed |
description | BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a high mortality. To date no trial comparing hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/RTV) has been performed. METHODS: Hospitalized patients ≥18 years old with severe coronavirus disease 2019 (COVID-19) were treated with either HCQ or LPV/RTV if they had either respiratory insufficiency (SpO(2) ≤ 93% on room air or the need for oxygen insufflation) or bilateral consolidations on chest X‑ray and at least 2 comorbidities associated with poor COVID-19 prognosis. Outcomes investigated included in-hospital mortality, intensive care unit (ICU) admission, length of stay, PCR (polymerase chain reaction) negativity and side effects of treatment. RESULTS: Of 156 patients (41% female) with a median age of 72 years (IQR 55.25–81) admitted to our department, 67 patients fulfilled the inclusion criteria (20 received HCQ, 47 LPV/RTV). Groups were comparable regarding most baseline characteristics. Median time from symptom onset to treatment initiation was 8 days and was similar between the groups (p = 0.727). There was no significant difference (HCQ vs. LPV/RTV) in hospital mortality (15% vs. 8.5%, p = 0.418), ICU admission rate (20% vs. 12.8%, p = 0.470) and length of stay (9 days vs. 11 days, p = 0.340). A PCR negativity from nasopharyngeal swabs was observed in approximately two thirds of patients in both groups. Side effects led to treatment discontinuation in 15% of patients in the LPV/RTV group. CONCLUSION: No statistically significant differences were observed in outcome parameters in patients treated with HCQ or LPV/RTV but patients in the LPV/RTV group showed a numerically lower hospital mortality rate. Additionally, in comparison to other studies we demonstrated a lower mortality in patients treated with LPV/RTV despite having similar patient groups, perhaps due to early initiation of treatment. |
format | Online Article Text |
id | pubmed-7416584 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Vienna |
record_format | MEDLINE/PubMed |
spelling | pubmed-74165842020-08-10 Hydroxychloroquine versus lopinavir/ritonavir in severe COVID-19 patients: Results from a real-life patient cohort Karolyi, Mario Pawelka, Erich Mader, Theresa Omid, Sara Kelani, Hasan Ely, Sarah Jilma, Bernd Baumgartner, Sebastian Laferl, Hermann Ott, Clemens Traugott, Marianna Turner, Michael Seitz, Tamara Wenisch, Christoph Zoufaly, Alexander Wien Klin Wochenschr Main Topic BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a high mortality. To date no trial comparing hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/RTV) has been performed. METHODS: Hospitalized patients ≥18 years old with severe coronavirus disease 2019 (COVID-19) were treated with either HCQ or LPV/RTV if they had either respiratory insufficiency (SpO(2) ≤ 93% on room air or the need for oxygen insufflation) or bilateral consolidations on chest X‑ray and at least 2 comorbidities associated with poor COVID-19 prognosis. Outcomes investigated included in-hospital mortality, intensive care unit (ICU) admission, length of stay, PCR (polymerase chain reaction) negativity and side effects of treatment. RESULTS: Of 156 patients (41% female) with a median age of 72 years (IQR 55.25–81) admitted to our department, 67 patients fulfilled the inclusion criteria (20 received HCQ, 47 LPV/RTV). Groups were comparable regarding most baseline characteristics. Median time from symptom onset to treatment initiation was 8 days and was similar between the groups (p = 0.727). There was no significant difference (HCQ vs. LPV/RTV) in hospital mortality (15% vs. 8.5%, p = 0.418), ICU admission rate (20% vs. 12.8%, p = 0.470) and length of stay (9 days vs. 11 days, p = 0.340). A PCR negativity from nasopharyngeal swabs was observed in approximately two thirds of patients in both groups. Side effects led to treatment discontinuation in 15% of patients in the LPV/RTV group. CONCLUSION: No statistically significant differences were observed in outcome parameters in patients treated with HCQ or LPV/RTV but patients in the LPV/RTV group showed a numerically lower hospital mortality rate. Additionally, in comparison to other studies we demonstrated a lower mortality in patients treated with LPV/RTV despite having similar patient groups, perhaps due to early initiation of treatment. Springer Vienna 2020-08-10 2021 /pmc/articles/PMC7416584/ /pubmed/32776298 http://dx.doi.org/10.1007/s00508-020-01720-y Text en © Springer-Verlag GmbH Austria, part of Springer Nature 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Main Topic Karolyi, Mario Pawelka, Erich Mader, Theresa Omid, Sara Kelani, Hasan Ely, Sarah Jilma, Bernd Baumgartner, Sebastian Laferl, Hermann Ott, Clemens Traugott, Marianna Turner, Michael Seitz, Tamara Wenisch, Christoph Zoufaly, Alexander Hydroxychloroquine versus lopinavir/ritonavir in severe COVID-19 patients: Results from a real-life patient cohort |
title | Hydroxychloroquine versus lopinavir/ritonavir in severe COVID-19 patients: Results from a real-life patient cohort |
title_full | Hydroxychloroquine versus lopinavir/ritonavir in severe COVID-19 patients: Results from a real-life patient cohort |
title_fullStr | Hydroxychloroquine versus lopinavir/ritonavir in severe COVID-19 patients: Results from a real-life patient cohort |
title_full_unstemmed | Hydroxychloroquine versus lopinavir/ritonavir in severe COVID-19 patients: Results from a real-life patient cohort |
title_short | Hydroxychloroquine versus lopinavir/ritonavir in severe COVID-19 patients: Results from a real-life patient cohort |
title_sort | hydroxychloroquine versus lopinavir/ritonavir in severe covid-19 patients: results from a real-life patient cohort |
topic | Main Topic |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416584/ https://www.ncbi.nlm.nih.gov/pubmed/32776298 http://dx.doi.org/10.1007/s00508-020-01720-y |
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