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10.1002/jia2.25489

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32293807!7158851!32293807
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suck abstract from ncbi


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pmid32293807      J+Int+AIDS+Soc 2020 ; 23 (4): e25489
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  • Systematic review of the efficacy and safety of antiretroviral drugs against SARS, MERS or COVID-19: initial assessment #MMPMID32293807
  • Ford N; Vitoria M; Rangaraj A; Norris SL; Calmy A; Doherty M
  • J Int AIDS Soc 2020[Apr]; 23 (4): e25489 PMID32293807show ga
  • INTRODUCTION: Several antiretroviral drugs are being considered for the treatment of COVID-19, the disease caused by a newly identified coronavirus, (SARS-CoV-2). We systematically reviewed the clinical outcomes of using antiretroviral drugs for the prevention and treatment of coronaviruses and planned clinical trials. METHODS: Three databases were screened from inception to 30 March 2020 for studies reporting clinical outcomes of patients with SARS, MERS or COVID-19 treated with antiretrovirals. RESULTS: From an initial screen of 433 titles, two randomized trials and 24 observational studies provided clinical outcome data on the use of antiretroviral drugs; most studies reported outcomes using LPV/r as treatment. Of the 21 observational studies reporting treatment outcomes, there were three studies among patients with SARS, six studies among patients with MERS and 12 studies among patients with COVID-19. In one randomized trial 99 patients with severe COVID-19 illness were randomized to receive LPV/r (400/100 mg twice a day) and 100 patients to standard of care for 14 days: LPV/r was not associated with a statistically significant difference in time to clinical improvement, although LPV/r given within 12 days of symptoms was associated with shorter time to clinical improvement; 28 day mortality was numerically lower in the LPV/r group (14/99) compared to the control group (25/100), but this difference was not statistically significant. The second trial found no benefit. The certainty of the evidence for the randomized trials was low. In the observational studies 3 out of 361 patients who received LPV/r died; the certainty of evidence was very low. Three studies reported a possible protective effect of LPV/r as post-exposure prophylaxis. Again, the certainty of the evidence was very low due to uncertainty due to limited sample size. CONCLUSIONS: On the basis of the available evidence it is uncertain whether LPV/r and other antiretrovirals improve clinical outcomes or prevent infection among patients at high risk of acquiring COVID-19.
  • |*Antiretroviral Therapy, Highly Active[MESH]
  • |Adult[MESH]
  • |Anti-Retroviral Agents/therapeutic use[MESH]
  • |Betacoronavirus[MESH]
  • |COVID-19[MESH]
  • |COVID-19 Drug Treatment[MESH]
  • |Coronavirus Infections/*drug therapy/epidemiology[MESH]
  • |Coronavirus/*drug effects/isolation & purification[MESH]
  • |Drug Combinations[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Lopinavir[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*drug therapy/epidemiology[MESH]
  • |Ritonavir[MESH]
  • |SARS-CoV-2[MESH]
  • |Severe Acute Respiratory Syndrome/drug therapy/epidemiology[MESH]


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