Abstract
Objectives: We aimed to compare the antiviral effect of hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/r) in patients with COVID-19.
Methods: Nationwide retrospective case-control study was conducted to compare the effect of HCQ and LPV/r on viral shedding duration among patients with mild-to-moderate COVID-19 using the reimbursement data of National Health Insurance Service. After propensity score matching (PSM), multivariate analysis was conducted to determine statistically significant risk factors associated with prolonged viral shedding.
Results: Overall, 4197 patients with mild-to-moderate COVID-19 were included. Patients were categorized into three groups: LPV/r (n = 1268), HCQ (n = 801), and standard care without HCQ or LPV/r (controls, n = 2128). The median viral shedding duration was 23 (IQR 17-32), 23 (IQR 16-32), and 18 (IQR 12-25) days in the LPV/r, HCQ, and control groups, respectively. Even after PSM, the viral shedding duration was not significantly different between LPV/r and HCQ groups: 23 (IQR, 17-32) days versus 23 (IQR, 16-32) days. On multivariate analysis, old age, malignancy, steroid use, and concomitant pneumonia were statistically significant risk factors for prolonged viral shedding.
Conclusion: The viral shedding duration was similar between HCQ and LPV/r treatment groups. There was no benefit in improving viral clearance compared to the control group.
Keywords: COVID-19; Hydroxychloroquine; Lopinavir; Ritonavir; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, Hydroxychloroquine, Lopinavir, Ritonavir, 【초록키워드】 SARS-CoV-2, Lopinavir/ritonavir, Hydroxychloroquine, Pneumonia, Lopinavir, Ritonavir, viral shedding, risk factor, viral clearance, Antiviral effect, Viral, Patient, age, HCQ, prolonged viral shedding, PSM, case-control study, Multivariate analysis, retrospective, Analysis, propensity score matching, Mild-to-moderate, malignancy, steroid, old age, Health Insurance, National Health Insurance, steroid use, insurance, control group, standard care, control groups, three groups, treatment groups, service, controls, benefit, conducted, median, determine, statistically significant, IQR, not significantly different, patients with COVID-19, 【제목키워드】 cohort study, Mild-to-moderate, COVID-19 case,