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AuthorElmekaty, Eman Zeyad I.
AuthorAlibrahim, Rim
AuthorHassanin, Rania
AuthorEltaib, Sitelbanat
AuthorElsayed, Ahmed
AuthorRustom, Fatima
AuthorMohamed Ibrahim, Mohamed Izham
AuthorAbu Khattab, Mohammed
AuthorAl Soub, Hussam
AuthorAl Maslamani, Muna
AuthorAl-Khal, Abdullatif
Available date2022-03-24T05:33:59Z
Publication Date2022
Publication NameJournal of Emergency Medicine, Trauma and Acute Care
Resourceqscience
CitationElmekaty EZI, Alibrahim R, Hassanin R, Eltaib S, Elsayed A, Rustom F, Ibrahim MIM, Khattab MA, Al Soub H, Al Maslamani M, Al-Khal A. Darunavir-Cobicistat versus Lopinavir-Ritonavir for COVID-19 Pneumonia: Qatar's Experience, Journal of Emergency Medicine, Trauma & Acute Care 2022:9 http://dx.doi.org/10.5339/jemtac.2022.qhc.9
ISSN1999-7086
ISSN1999-7094
URIhttps://doi.org/10.5339/jemtac.2022.qhc.9
URIhttp://hdl.handle.net/10576/28969
AbstractBackground: Coronavirus Disease 2019 (COVID-19) was first discovered in China and resulted in a pandemic crisis. 1,2 Many agents were investigated with inconclusive outcomes. 3 This study was conducted to compare the efficacy and safety outcomes of darunavir-cobicistat versus lopinavir-ritonavir in the treatment of patients with COVID-19. Methods: This retrospective, multicenter, observational study was conducted on adult patients hospitalized in COVID-19 facilities in Qatar. Patients were included if they had pneumonia and received darunavir-cobicistat or lopinavir-ritonavir for at least three days as part of their COVID-19 treatment. Data were collected from patients' electronic medical records. The primary outcome was a composite endpoint of time to clinical improvement and/or virological clearance. Data were analyzed descriptively and inferential statistics were applied at alpha level of 0.05. Results: A total of 400 patients' medical records were analyzed, of whom 100 received darunavir-cobicistat and 300 received lopinavir-ritonavir. The majority of patients were male (92.5%), with a mean (SD) time from symptoms onset to start of therapy of 7.57 days (SD 4.89). Patients who received lopinavir-ritonavir had a significantly faster time to the primary composite endpoint of clinical improvement and/or virological clearance than patients who received darunavir-cobicistat (4 days [IQR 3-7] vs. 6.5 days [IQR 4-12]; HR 1.345 [95%CI: 1.070-1.691], p = 0.011) [Figure 1]. Patients who received lopinavir-ritonavir had a significantly faster time to clinical improvement (5 days [IQR 3-8] vs. 8 days [IQR 4-13]; HR 1.520 (95%CI: 1.2-1.925), p = 0.000), and slower time to virological clearance than those who received darunavir-cobicistat (25 days [IQR 15-33] vs. 21 days [IQR 12.8-30]; HR 0.772 (95%CI: 0.607-0.982), p = 0.035) [Figure 2]. No significant difference in adverse events incidence or severity was observed. Conclusion: In patients with COVID-19, early treatment with lopinavir-ritonavir was associated with faster time to reach the primary composite endpoint of clinical improvement and/or virological clearance than treatment with darunavir-cobicistat. Future trials are warranted to confirm these findings.
Languageen
PublisherHamad bin Khalifa University Press (HBKU Press)
SubjectDarunavir-Cobicistat
Lopinavir-Ritonavir
COVID-19
Antiviral Therapy
Coronavirus
TitleDarunavir-Cobicistat versus Lopinavir-Ritonavir for COVID-19 Pneumonia: Qatar's Experience
TypeArticle
Issue Number1
Volume Number2022
dc.accessType Open Access


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