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- Title
Hydroxychloroquine versus lopinavir/ritonavir in severe COVID-19 patients: Results from a real-life patient cohort.
- Authors
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
- Abstract
Summary: 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 (SpO2 ≤ 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.
- Subjects
AUSTRIA; COVID-19; HYDROXYCHLOROQUINE; TERMINATION of treatment
- Publication
Wiener Klinische Wochenschrift, 2021, Vol 133, Issue 7/8, p284
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-020-01720-y