Veng Va Chau

Division of Pharmacy, Centro Hospitalar Conde de São Januário, Health Bureau, Macao SAR Government, China

Monotherapy with Lopinavir/Ritonavir or in Combination with Interferon Beta-1b in Patients with Non-severe COVID-19 Disease: A Clinical Case Series

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    Abstract

    The outbreak of Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV-2), has infected and killed millions of people worldwide. It has substantially increased the burden on healthcare system. However, the optimal approach to treatment of COVID-19 is uncertain. “Off-label” use of lopinavir/ritonavir (LPV/r) and interferons, particularly interferon beta (IFN-β), were the most suggested at the early stage. Although the United States National Institutes of Health’s (NIH) COVID-19 guidelines do not recommend the use of both medications for the treatment of COVID-19 in hospitalized patients, their roles in patients with non-severe disease are still unclear. Macau, a famous city for tourism, had 46 COVID-19 confirmed cases as of 2020. In this retrospective review, we summarized clinical and laboratory features of 39 COVID-19 patients admitted in the Centro Hospitalar Conde de São Januário (CHCSJ), of whom all did not receive oxygen therapy or ventilatory support during hospitalization. Of note, 12 (30.8%) of them were asymptomatic. The most common symptoms were fever and cough upon admission. They were all treated with LPV/r ± IFN-β-1b plus supportive care. The mean length of hospitalization was 26.6 (SD ± 12.6) days with LPV/r monotherapy, whereas 27.8 (SD ± 10.1) days with LPV/r/IFN-β-1b combination therapy (p=0.65). The percentage of 28-day negative results for polymerase chain reaction (PCR) test were 67.9% (19 of 28) with monotherapy and 63.6% (7 of 11) with combination therapy (p=0.80). No fatal case was reported and all patients discharged successfully. No beneficial clinical outcome was observed with the addition of IFN-β-1b to LPV/r-based therapy. Further studies are warranted to confirm these findings.