Choi, Min Joo; Kang, Minsun; Shin, So Youn; Noh, Ji Yun; Cheong, Hee Jin; Kim, Woo Joo; Jung, Jaehun; Song, Joon Young
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
2020Oct ; 81 ( 10 ) :.
PMID : 33127507
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Choi, Min Joo - Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
Kang, Minsun - Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon
Shin, So Youn - Department of Internal Medicine, International St. Mary's Hospital, Catholic
Noh, Ji Yun - Department of Internal Medicine, Korea University Guro Hospital, Korea University
Cheong, Hee Jin - Department of Internal Medicine, Korea University Guro Hospital, Korea University
Kim, Woo Joo - Department of Internal Medicine, Korea University Guro Hospital, Korea University
Jung, Jaehun - Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon
Song, Joon Young - Department of Internal Medicine, Korea University Guro Hospital, Korea University
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. CI - Copyright ??2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
keyword
COVID-19; Hydroxychloroquine; Lopinavir; Ritonavir; SARS-CoV-2
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