Abstract
BackgroundCurrently there is no proven medical treatment for COVID-19. We aimed to determine the factors affecting mortality and changes in clinical and laboratory findings in patients with severe COVID-19 pneumonia treated with lopinavir/ritonavir (Lpv/r).MethodsData of survivor and non-survivor severe COVID-19 pneumonia patients treated with Lpv/r were analysed retrospectively.ResultsA total of 73 patients, 26 (35.6%) females and 47 (64.4%) males were included in the study. The mean age of non-survivor and survivor patients was 64.3 ± 12 and 52.6 ± 12.2, respectively (p < 0.0001). Frequency of smoking and comorbid diseases was higher in non-survivor patients than in survivor patients (37% vs. 8.7% p = 0.003 and 92.6% vs. 28.3%, p < 0.0001, respectively). Age (Odds ratio [OR] 1.09, 95% confidence interval [95% CI] 1.03–1.14), smoking (OR 6.18, 1.7–22.42), presence of comorbid disease (OR 31.73, 6.26–153.56), coronary artery disease (OR 9.26, 1.79–47.77), arrhythmia (OR 13.8, 1.56–122.22), hypertension (OR 14, 4.28–45.74), diabetes (OR 7.22, 2–25.99) and congestive heart failure (OR 10.22, 1.13–92.93) were statistically associated with increased mortality (p < 0.05). Also increased neutrophil (OR 1.26, 1.08–1.46), C-reactive protein (CRP) (OR 1.01, 1.003–0.02), lactate dehydrogenase (LDH), (OR 1.002, 1.001–1.004), D-dimer (OR 1.001, 1.002–1.003), and aspartate transaminase (AST) levels (OR 1.05, 1.02–1.08 were associated with increased mortality.ConclusionThe presence of advanced age, active smoking, comorbidity, especially hypertension, diabetes, arrhythmia, coronary artery disease, congestive heart failure and neutrophil, C-reactive protein, lactate dehydrogenase, D-dimer and aspartate transaminase were associated with mortality. The efficacy of Lpv/r, warrants further verification in future studies.
Highlights
On December 2019, pneumonia cases caused by a new beta coronavirus turned into a pandemic that affected the whole world, starting in Wuhan, China
The World Health Organization (WHO) named this virus as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease caused by the virus was named as coronavirus disease-19 (COVID-19)
We reviewed the patients who died and survived under Lpv/r treatment in severe and critical COVID-19 patients in terms of demographic characteristics, smoking, comorbidities, laboratory parameters and clinical outcomes
Summary
On December 2019, pneumonia cases caused by a new beta coronavirus turned into a pandemic that affected the whole world, starting in Wuhan, China. The World Health Organization (WHO) named this virus as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease caused by the virus was named as coronavirus disease-19 (COVID-19). Lopinavir/ritonavir is thought to act by inhibiting 3CLpro proteinase, which is responsible for the processing of polypeptide product into protein components in the RNA genome in coronaviruses.[3] Scientific Committee of Turkish Ministry of Health guidelines of COVID-19 recommends Lpv/r use only in hypoxic patients with severe pneumonia (SpO2 level in the room air < 90%) and patients with an intermediate level disease in the presence of signs of progression under treatment with hydroxychloroquine.[4] http://www.sajid.co.za. We aimed to determine the factors affecting mortality and changes in clinical and laboratory findings in patients with severe COVID-19 pneumonia treated with lopinavir/ritonavir (Lpv/r)
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