A life-threatening respiratory illness (COVID-19) due to severe acute respiratory syndrome (SARS)-CoV-2 coronavirus was first described in December 2019 in Wuhan (China), rapidly evolving into a pandemic. In the first phase, when the viral replication plays a pivotal pathogenetic role, antiviral drugs could be crucial in limiting viral-induced organ damage. Unfortunately, there are no specific antivirals of proven efficacy for COVID-19, and several drugs have been repurposed to face this dramatic pandemic. In this paper we review the studies evaluating lopinavir/ritonavir association (LPV/r) use in COVID-19, and previously in SARS and Middle East respiratory syndrome (MERS). We searched PubMed to identify all relevant clinical and laboratory studies published up to 15 May 2020; the guidelines on the use of LPV/r in COVID-19 were further directly searched on the website of the main international scientific societies and agencies. Available evidence is currently scarce and of low quality. The recommendations issued for COVID-19 vary from positions clearly against the use of LPV/r to other positions that are more favorable. In our opinion, despite the controversial results of an important randomized clinical trial, and some recommendations, clinicians should not abandon the use of LPV/r for the treatment of COVID-19, possibly using this drug inside a prospective randomized trial, waiting for the results of the numerous ongoing trials evaluating its efficacy.
【저자키워드】 COVID-19, SARS, Lopinavir, Ritonavir, MERS, guideline, recommendation, 【초록키워드】 Treatment, randomized clinical trial, Efficacy, coronavirus, pandemic, Antiviral, randomized trial, Respiratory illness, drug, antiviral drug, Laboratory, China, viral replication, International, Wuhan, recommendations, association, Evidence, Middle East, acute respiratory syndrome, clinician, website, syndrome, life-threatening, organ damage, described, identify, searched, viral-induced, ongoing trial, 【제목키워드】 review, Lopinavir/ritonavir, role, current,