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Darunavir/Cobicistat Is Associated with Negative Outcomes in HIV-Negative Patients with Severe COVID-19 Pneumonia
- Publication Year :
- 2021
-
Abstract
- The aim of this study was to evaluate both positive outcomes, including reduction of respiratory support aid and duration of hospital stay, and negative ones, including mortality and a composite of invasive mechanical ventilation or death, in patients with coronavirus disease 2019 (COVID-19) pneumonia treated with or without oral darunavir/cobicistat (DRV/c, 800/150 mg/day) used in different treatment durations. The secondary objective was to evaluate the percentage of patients treated with DRV/c who were exposed to potentially severe drug-drug interactions (DDIs) and died during hospitalization. This observational retrospective study was conducted in consecutive patients with COVID-19 pneumonia admitted to a tertiary care hospital in Modena, Italy. Kaplan-Meier survival curves and Cox proportional hazards regression were used to compare patients receiving standard of care with or without DRV/c. Adjustment for key confounders was applied. Two hundred seventy-three patients (115 on DRV/c) were included, 75.8% males, mean age was 64.6 (±13.2) years. Clinical improvement was similar between the groups, depicted by respiratory aid switch (p > .05). The same was observed for duration of hospital stay [13.2 (±8.9) for DRV/c vs. 13.4 (±7.2) days for no-DRV/c, p = .9]. Patients on DRV/c had higher rates of mortality (25.2% vs. 10.1%, p < .0001. The rate of composite outcome of mechanical ventilation and death was higher in the DRV/c group (37.4% vs. 25.3%, p = .03). Multiple serious DDI associated with DRV/c were observed in the 19 patients who died. DRV/c should not be recommended as a treatment option for COVID-19 pneumonia outside clinical trials.
- Subjects :
- Adult
Male
0301 basic medicine
medicine.medical_specialty
Anti-HIV Agents
medicine.medical_treatment
Immunology
03 medical and health sciences
0302 clinical medicine
Virology
Internal medicine
medicine
Humans
030212 general & internal medicine
Survival analysis
Darunavir
Retrospective Studies
Mechanical ventilation
business.industry
SARS-CoV-2
Cobicistat
COVID-19
darunavir/cobicistat
negative outcomes
Confounding
Retrospective cohort study
Middle Aged
medicine.disease
COVID-19 Drug Treatment
Clinical trial
Drug Combinations
Pneumonia
030104 developmental biology
Infectious Diseases
Female
business
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....fab6a2ddab62c7e56bd69cfec34899ea