COVID-19 research briefs: small trial of lopinavir-ritonavir for patients hospitalized with COVID-19 shows no benefit

Daily POEMs

Published: 2020-04-25 © 2020 John Wiley & Sons, Inc.

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Clinical question
Can lopinavir-ritonavir improve outcomes for patients hospitalized with COVID-19?

Bottom line
A randomized trial of 199 patients found no evidence of benefit for lopinavir-ritonavir in patients with COVID-19. A larger trial is needed. (LOE = 2b)

Reference
Cao B, Wang Y, Wen D, et al. A trial of lopinavir-ritonavir in adults hospitalized with severe COVID-19. N Engl J Med 2020 Mar 18. doi: 10.1056/NEJMoa2001282. [Epub ahead of print].

Study design: Randomized controlled trial (nonblinded)

Funding source: Self-funded or unfunded

Allocation: Uncertain

Setting: Outpatient (primary care)

Synopsis
Research Brief #6 (Cao, 2020) In this open-label trial, researchers in Wuhan enrolled patients hospitalized with COVID-19 and oxygen saturation of 94% or less on room air. They randomized the patients to receive standard care (n = 100) or standard care plus an HIV-medication called lopinavir-ritonavir (Kaletra; 400 mg/ 100 mg; n = 99) twice a day for 14 days. They found no statistically significant difference in the duration of illness. Although the patients treated with lopinavir-ritonavir had 5.8% fewer deaths, this was not statistically significant. But in order to detect this difference a study would need more than 800 patients in each group. Stay tuned - hopefully, this will be studied further.

Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI

Copyright © 2020 John Wiley & Sons, Inc.