Real-World Efficacy and Safety of Lopinavir/Ritonavir and Arbidol in Treating with COVID-19: An Observational Cohort Study/ 洛匹那韦/利托那韦及阿比多尔治疗新型冠状病毒肺炎的疗效和安全性观察

Objective To evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) and arbidol in the treatment of COVID-19 in the real world Methods The clinical data of 178 patients diagnosed with COVID-19 admitted to Guangzhou Eighth People's Hospital were retrospectively analyzed from January 21 to February 9, 2020 According to the patient's antiviral treatment regimen, 178 patients were divided into 4 groups including LPV/r group (59 patients), arbidol group (36 patients), combination therapy with LPV/r plus arbidol group (25 patients) and the conventional treatment group without any antiviral drugs (58 patients) The main observation end points of the study was the negative conversion time of nucleic acid of the novel coronavirus (2019-nCoV) in pharyngeal swab Results The baseline of 4 groups before treatment was consistent and comparable The negative conversion time of nucleic acid of the 2019-nCoV in pharyngeal swab was (10 20 ± 3 49), (10 11 ± 4 68), (10 86 ± 4 74), (8 44 ± 3 51) days separately in the LPV/r group, the arbidol group, the combination therapy group, and the conventional treatment group without significant difference (F = 2 556, P = 0 058) There was also no significant difference in the rate of negative conversion rate of 2019-nCoV nucleic acid, the improvement ration in clinical symptoms, and the improvement ration of pulmonary infection in the lung CT imaging (P> 0 05) However, a statistically significant difference was found in the proportion of deterioration changing from mild/moderate to severe/critical type at day 7 (χ2 = 9 311, P = 0 017) as follows: the combination therapy group (24 0%, 6/25), the arbidol group ( 16 7%, 6/36), LPV/r group (5 4%, 3/56) and conventional treatment group (5 2%, 3/58) Moreover, the frequency of adverse reactions in the three groups receiving antiviral drugs was significantly higher than that in the conventional treatment group (χ2 = 14 875, P = 0 002) Conclusions No evidences could prove that LPV/r and arbidol could shorten the negative conversion time of novel coronavirus nucleic acid in pharyngeal swab nor improve the symptoms of patients Furthermore, the combination usage of LPV/r and arbidol may not benefit for improving the disease Noteworthy, the adverse reactions of the antiviral drugs should be paid careful attention during the treatment