Comparison of antiviral effect for mild-to-moderate COVID-19 cases between lopinavir/ritonavir versus hydroxychloroquine: A nationwide propensity score-matched cohort study.
Identifieur interne : 000921 ( Main/Corpus ); précédent : 000920; suivant : 000922Comparison of antiviral effect for mild-to-moderate COVID-19 cases between lopinavir/ritonavir versus hydroxychloroquine: A nationwide propensity score-matched cohort study.
Auteurs : Min Joo Choi ; Minsun Kang ; So Youn Shin ; Ji Yun Noh ; Hee Jin Cheong ; Woo Joo Kim ; Jaehun Jung ; Joon Young SongSource :
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [ 1878-3511 ] ; 2021.
English descriptors
- KwdEn :
- Adult (MeSH), Antiviral Agents (therapeutic use), COVID-19 (drug therapy), COVID-19 (virology), Drug Therapy, Combination (MeSH), Female (MeSH), Humans (MeSH), Hydroxychloroquine (therapeutic use), Lopinavir (administration & dosage), Male (MeSH), Middle Aged (MeSH), Propensity Score (MeSH), Retrospective Studies (MeSH), Ritonavir (administration & dosage), SARS-CoV-2 (MeSH), Virus Shedding (drug effects), Young Adult (MeSH).
- MESH :
- chemical , administration & dosage : Lopinavir, Ritonavir.
- chemical , therapeutic use : Antiviral Agents, Hydroxychloroquine.
- drug effects : Virus Shedding.
- drug therapy : COVID-19.
- virology : COVID-19.
- Adult, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Propensity Score, Retrospective Studies, SARS-CoV-2, Young Adult.
Abstract
OBJECTIVES
We aimed to compare the antiviral effect of hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/r) in patients with COVID-19.
METHODS
Nationwide retrospective case-control study was conducted to compare the effect of HCQ and LPV/r on viral shedding duration among patients with mild-to-moderate COVID-19 using the reimbursement data of National Health Insurance Service. After propensity score matching (PSM), multivariate analysis was conducted to determine statistically significant risk factors associated with prolonged viral shedding.
RESULTS
Overall, 4197 patients with mild-to-moderate COVID-19 were included. Patients were categorized into three groups: LPV/r (n = 1268), HCQ (n = 801), and standard care without HCQ or LPV/r (controls, n = 2128). The median viral shedding duration was 23 (IQR 17-32), 23 (IQR 16-32), and 18 (IQR 12-25) days in the LPV/r, HCQ, and control groups, respectively. Even after PSM, the viral shedding duration was not significantly different between LPV/r and HCQ groups: 23 (IQR, 17-32) days versus 23 (IQR, 16-32) days. On multivariate analysis, old age, malignancy, steroid use, and concomitant pneumonia were statistically significant risk factors for prolonged viral shedding.
CONCLUSION
The viral shedding duration was similar between HCQ and LPV/r treatment groups. There was no benefit in improving viral clearance compared to the control group.
DOI: 10.1016/j.ijid.2020.10.062
PubMed: 33127507
PubMed Central: PMC7590837
Links to Exploration step
pubmed:33127507Le document en format XML
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<affiliation><nlm:affiliation>Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.</nlm:affiliation>
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<author><name sortKey="Kang, Minsun" sort="Kang, Minsun" uniqKey="Kang M" first="Minsun" last="Kang">Minsun Kang</name>
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<author><name sortKey="Shin, So Youn" sort="Shin, So Youn" uniqKey="Shin S" first="So Youn" last="Shin">So Youn Shin</name>
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<author><name sortKey="Noh, Ji Yun" sort="Noh, Ji Yun" uniqKey="Noh J" first="Ji Yun" last="Noh">Ji Yun Noh</name>
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<author><name sortKey="Kim, Woo Joo" sort="Kim, Woo Joo" uniqKey="Kim W" first="Woo Joo" last="Kim">Woo Joo Kim</name>
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<author><name sortKey="Jung, Jaehun" sort="Jung, Jaehun" uniqKey="Jung J" first="Jaehun" last="Jung">Jaehun Jung</name>
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<author><name sortKey="Shin, So Youn" sort="Shin, So Youn" uniqKey="Shin S" first="So Youn" last="Shin">So Youn Shin</name>
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<term>COVID-19 (drug therapy)</term>
<term>COVID-19 (virology)</term>
<term>Drug Therapy, Combination (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Hydroxychloroquine (therapeutic use)</term>
<term>Lopinavir (administration & dosage)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Propensity Score (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Ritonavir (administration & dosage)</term>
<term>SARS-CoV-2 (MeSH)</term>
<term>Virus Shedding (drug effects)</term>
<term>Young Adult (MeSH)</term>
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<term>Ritonavir</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term>
<term>Hydroxychloroquine</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b>
</p>
<p>We aimed to compare the antiviral effect of hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/r) in patients with COVID-19.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Nationwide retrospective case-control study was conducted to compare the effect of HCQ and LPV/r on viral shedding duration among patients with mild-to-moderate COVID-19 using the reimbursement data of National Health Insurance Service. After propensity score matching (PSM), multivariate analysis was conducted to determine statistically significant risk factors associated with prolonged viral shedding.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Overall, 4197 patients with mild-to-moderate COVID-19 were included. Patients were categorized into three groups: LPV/r (n = 1268), HCQ (n = 801), and standard care without HCQ or LPV/r (controls, n = 2128). The median viral shedding duration was 23 (IQR 17-32), 23 (IQR 16-32), and 18 (IQR 12-25) days in the LPV/r, HCQ, and control groups, respectively. Even after PSM, the viral shedding duration was not significantly different between LPV/r and HCQ groups: 23 (IQR, 17-32) days versus 23 (IQR, 16-32) days. On multivariate analysis, old age, malignancy, steroid use, and concomitant pneumonia were statistically significant risk factors for prolonged viral shedding.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>The viral shedding duration was similar between HCQ and LPV/r treatment groups. There was no benefit in improving viral clearance compared to the control group.</p>
</div>
</front>
</TEI>
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<ArticleTitle>Comparison of antiviral effect for mild-to-moderate COVID-19 cases between lopinavir/ritonavir versus hydroxychloroquine: A nationwide propensity score-matched cohort study.</ArticleTitle>
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<Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">We aimed to compare the antiviral effect of hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/r) in patients with COVID-19.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Nationwide retrospective case-control study was conducted to compare the effect of HCQ and LPV/r on viral shedding duration among patients with mild-to-moderate COVID-19 using the reimbursement data of National Health Insurance Service. After propensity score matching (PSM), multivariate analysis was conducted to determine statistically significant risk factors associated with prolonged viral shedding.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Overall, 4197 patients with mild-to-moderate COVID-19 were included. Patients were categorized into three groups: LPV/r (n = 1268), HCQ (n = 801), and standard care without HCQ or LPV/r (controls, n = 2128). The median viral shedding duration was 23 (IQR 17-32), 23 (IQR 16-32), and 18 (IQR 12-25) days in the LPV/r, HCQ, and control groups, respectively. Even after PSM, the viral shedding duration was not significantly different between LPV/r and HCQ groups: 23 (IQR, 17-32) days versus 23 (IQR, 16-32) days. On multivariate analysis, old age, malignancy, steroid use, and concomitant pneumonia were statistically significant risk factors for prolonged viral shedding.</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The viral shedding duration was similar between HCQ and LPV/r treatment groups. There was no benefit in improving viral clearance compared to the control group.</AbstractText>
<CopyrightInformation>Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation>
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<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Choi</LastName>
<ForeName>Min Joo</ForeName>
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<ForeName>Hee Jin</ForeName>
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</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Song</LastName>
<ForeName>Joon Young</ForeName>
<Initials>JY</Initials>
<AffiliationInfo><Affiliation>Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: infection@korea.ac.kr.</Affiliation>
</AffiliationInfo>
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