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Lopinavir/Ritonavir, Umifenovir Ineffective for Mild COVID-19

Rate of positive-to-negative conversion of SARS-CoV-2 did not differ for drug therapy versus standard care

THURSDAY, April 23, 2020 (HealthDay News) -- For patients hospitalized with mild/moderate COVID-19, lopinavir/ritonavir (LPV/r) or umifenovir (Arbidol) monotherapy offers little benefit, according to a study published online April 17 in Med.

Yueping Li, M.D., Ph.D., from the Guangzhou Eighth People's Hospital in China, and colleagues conducted an exploratory randomized trial assessing the efficacy and safety of LPV/r or umifenovir monotherapy for treating patients with mild/moderate COVID-19. Eighty-six patients were enrolled, with 34 randomly assigned to LPV/r, 35 to umifenovir, and 17 to no antiviral medication as control. Umifenovir is an antiviral treatment for influenza infection currently only used in Russia and China.

The researchers found that the rate of positive-to-negative conversion of severe acute respiratory syndrome coronavirus 2 nucleic acid (primary end point) was similar between the groups. No between-group differences were seen in secondary end points of rates of antipyresis, cough alleviation, or improvement of chest computed tomography at days 7 or 14. At day 7, a deterioration in clinical status from moderate to severe/critical was seen for 23.5, 8.6, and 11.8 percent of patients in the LPV/r, umifenovir, and control groups, respectively. During the follow-up period, 35.3 and 14.3 percent of patients in the LPV/r and umifenovir groups, respectively, experienced adverse events. In the control group, there were no adverse events reported.

"Our findings suggest that we need to cautiously consider before using these drugs," Li said in a statement. "Researchers need to keep working to find a really effective antiviral regimen against COVID-19, but meanwhile, any conclusions about antiviral regimens need strict and scientific clinical trials and appropriate caution."

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