Efficacy and Safety of Lopinavir/Ritonavir for Treatment of COVID-19: A Systematic Review and Meta-Analysis.
Efficacy and Safety of Lopinavir/Ritonavir for Treatment of COVID-19: A Systematic Review and Meta-Analysis.
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DOI：
10.3390/tropicalmed5040180
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发表时间：
2020-11-28
影响因子：
2.9
通讯作者：
Tobaiqy M
中科院分区：
文献类型：
--
作者：
Alhumaid S;Mutair AA;Alawi ZA;Alhmeed N;Zaidi ARZ;Tobaiqy M
（背景）洛匹那韦-利托那韦（LPV/RTV）是一种人类免疫缺陷病毒（HIV）抗病毒组合，已被考虑用于治疗COVID-19疾病。(Aim)本系统性综述旨在评估已发表研究中LPV/RTV在COVID-19患者中的疗效和安全性。（方法）根据PRISMA（Preferred Reporting Items for Systematic Reviews and Meta Analysis）的声明制定方案。从8个电子数据库中选择文章进行综述。本综述评价了LPV/RTV单独或联合标准治疗±干扰素/抗病毒治疗与其他治疗相比的效果，包括住院时间、进展为侵入性机械治疗的风险、病毒学治愈和体温正常化的时间、咳嗽缓解、放射学进展、死亡率和安全性。结果共筛选出32篇文献进行全文筛选，共纳入14篇文献（9036例患者），其中8篇纳入Meta分析。这些研究中的大多数没有报告LPV/RTV治疗的积极临床结局。在病毒学治愈方面，3项研究报告了LPV/RTV组达到病毒学治愈的时间（天）少于无抗病毒治疗组（-0.81天; 95%置信区间（CI），-4.44至2.81; p = 0.007，I2 = 80%）。然而，总体效果不显著（p = 0.66）。当比较LPV/RTV组与乌非诺韦组时，观察到乌非诺韦组的有利影响，但不具有统计学显著性（p = 0.09）。在身体恢复正常和咳嗽缓解的时间方面，未观察到LPV/RTV相对于umifenovir的有利作用。最大规模的试验（RECOVERY和SOLIDARITY）表明，LPV/RTV未能降低死亡率、有创机械通气的开始时间或住院时间。相对于其他抗病毒药物和无抗病毒治疗，LPV/RTV（n = 84）最常报告不良事件。（结论）该综述未显示LPV/RTV治疗COVID-19的疗效优于标准治疗、无抗病毒药物或其他抗病毒治疗。这一结果可能并不反映实际证据。
(Background) Lopinavir-ritonavir (LPV/RTV) is a human immunodeficiency virus (HIV) antiviral combination that has been considered for the treatment of COVID-19 disease. (Aim) This systematic review aimed to assess the efficacy and safety of LPV/RTV in COVID-19 patients in the published research. (Methods) A protocol was developed based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement. Articles were selected for review from 8 electronic databases. This review evaluated the effects of LPV/RTV alone or in combination with standard care ± interferons/antiviral treatments compared to other therapies, regarding duration of hospital stay, risk of progressing to invasive mechanical, time to virological cure and body temperature normalization, cough relief, radiological progression, mortality and safety. (Results) A consensus was reached to select 32 articles for full-text screening; only 14 articles comprising 9036 patients were included in this study; and eight of these were included for meta-analysis. Most of these studies did not report positive clinical outcomes with LPV/RTV treatment. In terms of virological cure, three studies reported less time in days to achieve a virological cure for LPV/RTV arm relative to no antiviral treatment (−0.81 day; 95% confidence interval (CI), −4.44 to 2.81; p = 0.007, I2 = 80%). However, the overall effect was not significant (p = 0.66). When comparing the LPV/RTV arm to umifenovir arm, a favorable affect was observed for umifenovir arm, but not statically significant (p = 0.09). In terms of time to body normalization and cough relief, no favorable effects of LPV/RTV versus umifenovir were observed. The largest trials (RECOVERY and SOLIDARITY) have shown that LPV/RTV failed to reduce mortality, initiation of invasive mechanical ventilation or hospitalization duration. Adverse events were reported most frequently for LPV/RTV (n = 84) relative to other antivirals and no antiviral treatments. (Conclusions) This review did not reveal any significant advantage in efficacy of LPV/RTV for the treatment of COVID-19 over standard care, no antivirals or other antiviral treatments. This result might not reflect the actual evidence.
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DOI：
10.3390/v10040184
发表时间：
2018-04-10
期刊：
Viruses
影响因子：
--
作者：
Haviernik J;Štefánik M;Fojtíková M;Kali S;Tordo N;Rudolf I;Hubálek Z;Eyer L;Ruzek D
通讯作者：
Ruzek D
影响因子：
7.6
作者：
Choy, Ka-Tim;Wong, Alvina Yin-Lam;Yen, Hui-Ling
通讯作者：
Yen, Hui-Ling
影响因子：
0.6
作者：
Alhumaid, Saad;Tobaiqy, Mansour;Alali, Jalal
通讯作者：
Alali, Jalal
影响因子：
14.2
作者：
Lian, N.;Xie, H.;Lin, Q.
通讯作者：
Lin, Q.
影响因子：
17
作者：
Li, Yueping;Xie, Zhiwei;Li, Linghua
通讯作者：
Li, Linghua