Arbidol monotherapy is superior to lopinavir/ritonavir in treating COVID-19

• Published in: The Journal of infection 2020-07, Vol.81 (1), p.e21-e23
• Main Authors: Zhu, Zhen, Lu, Zhaohui, Xu, Tianmin, Chen, Cong, Yang, Gang, Zha, Tao, Lu, Jianchun, Xue, Yuan
• Format: Article
• Language: English
• Subjects: Adult; Antiviral Agents - administration & dosage; Antiviral Agents - therapeutic use; Antiviral therapy; Betacoronavirus; Coronavirus Infections - drug therapy; Coronavirus Infections - virology; COVID-19; Ct value; Drug Combinations; Female; Humans; Indoles - administration & dosage; Indoles - adverse effects; Indoles - therapeutic use; Lopinavir - adverse effects; Lopinavir - therapeutic use; Male; Middle Aged; Pandemics; Pneumonia; Pneumonia, Viral - drug therapy; Pneumonia, Viral - virology; Retrospective Studies; Ritonavir - adverse effects; Ritonavir - therapeutic use; SARS-CoV-2; SARS-CoV2; Viral Load
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2020.03.060

•On day 14 after the admission, no viral load was detected in arbidol group.•44.1% of patients in lopinavir/ritonavir group had positive RNA test on day 14.•Patients in the arbidol group had a shorter duration of positive RNA test.•No apparent side effects were found in both groups.•Arbidol monotherapy may be superior to lopinavir/ritonavir in treating COVID-19. Lopinavir/ritonavir and arbidol have been previously used to treat acute respiratory syndrome- coronavirus 2 (SARS-CoV-2) replication in clinical practice; nevertheless, their effectiveness remains controversial. In this study, we evaluated the antiviral effects and safety of lopinavir/ritonavir and arbidol in patients with the 2019-nCoV disease (COVID-19). Fifty patients with laboratory-confirmed COVID-19 were divided into two groups: including lopinavir/ritonavir group (34 cases) and arbidol group (16 cases). Lopinavir/ritonavir group received 400 mg/100mg of Lopinavir/ritonavir, twice a day for a week, while the arbidol group was given 0.2 g arbidol, three times a day. Data from these patients were retrospectively analyzed. The cycle threshold values of open reading frame 1ab and nucleocapsid genes by RT-PCR assay were monitored during antiviral therapy. None of the patients developed severe pneumonia or ARDS. There was no difference in fever duration between the two groups (P=0.61). On day 14 after the admission, no viral load was detected in arbidol group, but the viral load was found in 15(44.1%) patients treated with lopinavir/ritonavir. Patients in the arbidol group had a shorter duration of positive RNA test compared to those in the lopinavir/ritonavir group (P