Background Robust evidenced treatment strategy for Coronavirus disease 2019 (COVID-19) has not been established yet. Early, targeted, comprehensive management approach can be essential. Methods A lopinavir/ritonavir (LPV/r)-based antiviral treatment was administered to the patients with computed tomography (CT)-documented pneumonia. Medical records of patients with COVID-19, previously discharged or hospitalized for ≥ 21 days at the Seoul Medical Center from January 29 to April 15, 2020 were reviewed to analyze clinical and virological outcomes. Patients were divided into two groups (PCR-Negative conversion group vs. Non-negative conversion group and requiring oxygen group vs. Non-requiring oxygen group). Results In total, 136 patients with a mean age of 41.8 ± 18.2 years were included with median 3-day delay of hospitalization after illness. Thirteen (9.56%) were initially asymptomatic, and 5 (3.67%) were persistently asymptomatic. Eighty-five (62.5%) had CT-documented pneumonia, 94% of whom received LPV/r treatments. A total of 53 patients (38.97%) had negative polymerase chain reaction (PCR) results within 28 days. Eight (9.4%) out of 85 pneumonic patients received oxygen supplementation. Patients with initial lower respiratory symptoms showed significant delay in PCR negative conversion (> 28 days) (odds ratio [OR] 0.166; 95% confidence interval [CI] 0.067–0.477; P < 0.001). However, antiviral treatment for pneumonic patients was significantly related with early conversion within 28 days (OR 3.049; 95% CI 1.128–8.243; P = 0.028). Increasing age increased the likelihood of oxygen supplementation requirement in the pneumonic patient group (OR 1.108; 95% CI 1.021–1.202; P = 0.014). Conclusions Early, pneumonia targeted LPV/r-based antiviral therapy resulted in a significantly higher probability of negative conversion of PCR within 28 days compared to symptomatic treatment.
【저자키워드】 Treatment outcome, Lopinavir/ritonavir, Coronavirus disease 2019 (COVID-19), Virus shedding, Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2, 【초록키워드】 COVID-19, Treatment, coronavirus disease, antiviral therapy, Coronavirus disease 2019, Hospitalized, Lopinavir/ritonavir, Hospitalization, Pneumonia, Lopinavir, Ritonavir, oxygen, Antiviral treatment, Computed tomography, Probability, polymerase chain reaction, PCR, Asymptomatic, management, virological outcomes, Patient, Symptomatic treatment, age, respiratory, Odds ratio, medical records, Chain Reaction, medical record, two groups, 95% CI, 95% confidence interval, Negative conversion, center, increasing age, respiratory symptom, significant delay, oxygen supplementation, pneumonic, Administered, approach, likelihood, polymerase chain, initial, Result, significantly, the patient, median, significantly higher, two group, discharged, evidenced, Increasing, patients with COVID-19, 【제목키워드】 Treatment, Patient, retrospective, single center,