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Lopinavir/Ritonavir and Darunavir/Cobicistat in Hospitalized COVID-19 Patients: Findings From the Multicenter Italian CORIST Study

Authors :
Augusto Di Castelnuovo
Simona Costanzo
Andrea Antinori
Nausicaa Berselli
Lorenzo Blandi
Marialaura Bonaccio
Raffaele Bruno
Roberto Cauda
Alessandro Gialluisi
Giovanni Guaraldi
Lorenzo Menicanti
Marco Mennuni
Ilaria My
Agostino Parruti
Giuseppe Patti
Stefano Perlini
Francesca Santilli
Carlo Signorelli
Giulio G. Stefanini
Alessandra Vergori
Walter Ageno
Luca Aiello
Piergiuseppe Agostoni
Samir Al Moghazi
Rosa Arboretti
Filippo Aucella
Greta Barbieri
Martina Barchitta
Alessandro Bartoloni
Carolina Bologna
Paolo Bonfanti
Lucia Caiano
Laura Carrozzi
Antonio Cascio
Giacomo Castiglione
Mauro Chiarito
Arturo Ciccullo
Antonella Cingolani
Francesco Cipollone
Claudia Colomba
Crizia Colombo
Francesco Crosta
Giovanni Dalena
Chiara Dal Pra
Gian Battista Danzi
Damiano D'Ardes
Katleen de Gaetano Donati
Francesco Di Gennaro
Giuseppe Di Tano
Gianpiero D'Offizi
Tommaso Filippini
Francesco Maria Fusco
Carlo Gaudiosi
Ivan Gentile
Giancarlo Gini
Elvira Grandone
Gabriella Guarnieri
Gennaro L. F. Lamanna
Giovanni Larizza
Armando Leone
Veronica Lio
Angela Raffaella Losito
Gloria Maccagni
Stefano Maitan
Sandro Mancarella
Rosa Manuele
Massimo Mapelli
Riccardo Maragna
Lorenzo Marra
Giulio Maresca
Claudia Marotta
Franco Mastroianni
Maria Mazzitelli
Alessandro Mengozzi
Francesco Menichetti
Jovana Milic
Filippo Minutolo
Beatrice Molena
R. Mussinelli
Cristina Mussini
Maria Musso
Anna Odone
Marco Olivieri
Emanuela Pasi
Annalisa Perroni
Francesco Petri
Biagio Pinchera
Carlo A. Pivato
Venerino Poletti
Claudia Ravaglia
Marco Rossato
Marianna Rossi
Anna Sabena
Francesco Salinaro
Vincenzo Sangiovanni
Carlo Sanrocco
Laura Scorzolini
Raffaella Sgariglia
Paola Giustina Simeone
Michele Spinicci
Enrico Maria Trecarichi
Giovanni Veronesi
Roberto Vettor
Andrea Vianello
Marco Vinceti
Elena Visconti
Laura Vocciante
Raffaele De Caterina
Licia Iacoviello
The COVID-19 RISK and Treatments (CORIST) Collaboration
Source :
Frontiers in Medicine, Vol 8 (2021)
Publication Year :
2021
Publisher :
Frontiers Media S.A., 2021.

Abstract

Background: Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients.Objectives: To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients.Study Design: Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals. Medications, preexisting conditions, clinical measures, and outcomes were extracted from medical records. Patients were retrospectively divided in three groups, according to use of LPV/r, DRV/c or none of them. Primary outcome in a time-to event analysis was death. We used Cox proportional-hazards models with inverse probability of treatment weighting by multinomial propensity scores.Results: Out of 3,451 patients, 33.3% LPV/r and 13.9% received DRV/c. Patients receiving LPV/r or DRV/c were more likely younger, men, had higher C-reactive protein levels while less likely had hypertension, cardiovascular, pulmonary or kidney disease. After adjustment for propensity scores, LPV/r use was not associated with mortality (HR = 0.94, 95% CI 0.78 to 1.13), whereas treatment with DRV/c was associated with a higher death risk (HR = 1.89, 1.53 to 2.34, E-value = 2.43). This increased risk was more marked in women, in elderly, in patients with higher severity of COVID-19 and in patients receiving other COVID-19 drugs.Conclusions: In a large cohort of Italian patients hospitalized for COVID-19 in a real-life setting, the use of LPV/r treatment did not change death rate, while DRV/c was associated with increased mortality. Within the limits of an observational study, these data do not support the use of LPV/r or DRV/c in COVID-19 patients.

Details

Language :
English
ISSN :
2296858X
Volume :
8
Database :
Directory of Open Access Journals
Journal :
Frontiers in Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.f4c84c197fec47feaef5530f66820b4b
Document Type :
article
Full Text :
https://doi.org/10.3389/fmed.2021.639970