6533b836fe1ef96bd12a0b6e
RESEARCH PRODUCT
Lopinavir/ritonavir and darunavir/cobicistat in hospitalized covid-19 patients: Findings from the multicenter italian corist study
Augusto Di CastelnuovoSimona CostanzoAndrea AntinoriNausicaa BerselliLorenzo BlandiMarialaura BonaccioRaffaele BrunoRaffaele BrunoRoberto CaudaRoberto CaudaAlessandro GialluisiGiovanni GuaraldiLorenzo MenicantiMarco MennuniIlaria MyAgostino ParrutiGiuseppe PattiStefano PerliniStefano PerliniFrancesca SantilliCarlo SignorelliGiulio G. StefaniniAlessandra VergoriWalter AgenoLuca AielloPiergiuseppe AgostoniPiergiuseppe AgostoniSamir Al MoghaziRosa ArborettiFilippo AucellaGreta BarbieriMartina BarchittaAlessandro BartoloniCarolina BolognaPaolo BonfantiPaolo BonfantiLucia CaianoLaura CarrozziAntonio CascioGiacomo CastiglioneMauro ChiaritoArturo CicculloAntonella CingolaniAntonella CingolaniFrancesco CipolloneClaudia ColombaCrizia ColomboFrancesco CrostaGiovanni DalenaChiara Dal PraGian Battista DanziDamiano D'ardesKatleen De Gaetano DonatiFrancesco Di GennaroGiuseppe Di TanoGianpiero D'offiziTommaso FilippiniFrancesco Maria FuscoCarlo GaudiosiIvan GentileGiancarlo GiniElvira GrandoneGabriella GuarnieriGennaro L. F. LamannaGiovanni LarizzaArmando LeoneVeronica LioAngela Raffaella LositoGloria MaccagniStefano MaitanSandro MancarellaRosa ManueleMassimo MapelliMassimo MapelliRiccardo MaragnaRiccardo MaragnaLorenzo MarraGiulio MarescaClaudia MarottaFranco MastroianniMaria MazzitelliAlessandro MengozziFrancesco MenichettiJovana MilicFilippo MinutoloBeatrice MolenaR. MussinelliCristina MussiniMaria MussoAnna OdoneMarco OlivieriEmanuela PasiAnnalisa PerroniFrancesco PetriBiagio PincheraCarlo A. PivatoVenerino PolettiClaudia RavagliaMarco RossatoMarianna RossiAnna SabenaSalinaro FrancescoVincenzo SangiovanniCarlo SanroccoLaura ScorzoliniRaffaella SgarigliaPaola Giustina SimeoneMichele SpinicciEnrico Maria TrecarichiGiovanni VeronesiRoberto VettorAndrea VianelloMarco VincetiMarco VincetiElena ViscontiLaura VoccianteRaffaele De CaterinaLicia IacovielloLicia IacovielloThe Covid-19 Risk And Treatments (Corist) Collaborationsubject
Medicine (General)medicine.medical_specialtyLopinavir/ritonavirLopinavirR5-920Internal medicinemedicineDarunavirOriginal ResearchCOVID-19; Darunavir; In-hospital mortality; Lopinavir; SARS-CoV-2DarunavirCOVID-19; SARS-CoV-2; darunavir; in-hospital mortality; lopinavirbusiness.industrySARS-CoV-2CobicistatMortality rateCOVID-19LopinavirGeneral Medicinemedicine.diseaseIn-hospital mortalityPropensity score matchingMedicineRitonavirbusinessmedicine.drugKidney diseasedescription
Background: Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients.Objectives: To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients.Study Design: Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals. Medications, preexisting conditions, clinical measures, and outcomes were extracted from medical records. Patients were retrospectively divided in three groups, according to use of LPV/r, DRV/c or none of them. Primary outcome in a time-to event analysis was death. We used Cox proportional-hazards models with inverse probability of treatment weighting by multinomial propensity scores.Results: Out of 3,451 patients, 33.3% LPV/r and 13.9% received DRV/c. Patients receiving LPV/r or DRV/c were more likely younger, men, had higher C-reactive protein levels while less likely had hypertension, cardiovascular, pulmonary or kidney disease. After adjustment for propensity scores, LPV/r use was not associated with mortality (HR = 0.94, 95% CI 0.78 to 1.13), whereas treatment with DRV/c was associated with a higher death risk (HR = 1.89, 1.53 to 2.34, E-value = 2.43). This increased risk was more marked in women, in elderly, in patients with higher severity of COVID-19 and in patients receiving other COVID-19 drugs.Conclusions: In a large cohort of Italian patients hospitalized for COVID-19 in a real-life setting, the use of LPV/r treatment did not change death rate, while DRV/c was associated with increased mortality. Within the limits of an observational study, these data do not support the use of LPV/r or DRV/c in COVID-19 patients.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-06-09 |