Comparison of non-severe COVID-19 pneumonia patients treated with lopinavir/ritonavir and favipiravir

Abstract

Aim: There is no proven medical treatment for COVID-19 to date. We aimed to evaluate the effectiveness of LPV/r and FVR treatments in non-severe COVID-19 pneumonia patients and compare the clinical outcomes. Methods: In this retrospective cohort study, the data of non-severe COVID-19 pneumonia patients treated with lopinavir/ritonavir and FVR were analyzed. Results: A total of 91 non-severe COVID-19 patients, 33 (36.2%) treated with LPV/r and 58 (63.8%) treated with FVR, were included in the study. The mean ages of the LPV/r group and FVR group were 53.1 (13) years and 57.2 (17.44) years, respectively (P=0.24). There was no statistically significant difference between the two groups in terms of comorbidities (P=0.06). FVR patients had higher radiological weight scores than LPV/r patients, but this was not statistically significant (8.67 (3.7) vs 7.66 (3.22) P=0.2, respectively). While SpO2 levels of FVR patients at the time of admission were lower than those of LPV/r patients, CRP levels were higher (92.22 (2.8) vs 97.87 (2.05), P<0.001, respectively and 75.42 (62) vs 45.42 (49.92), P=0.02, respectively). FVR patients had a shorter fever regression time than LPV/r patients (2.7 (0.9) vs 4 (1), P<0.001, respectively). Post-treatment neutrophil, lymphocyte, N/L ratio and DDimer levels decreased more in FVR group compared to the LPV/r group (P=0.01, <0.001, 0.001, <0.001, respectively). Conclusion: Although non-severe COVID-19 patients using FVR had lower oxygen saturations, more widespread radiological involvement, and higher CRP levels at admission, we found that FVR was more effective in improving laboratory parameters and controlling fever than LPV/r treatment. The efficacy of lopinavir/ritonavir and FVR warrants further verification by future, larger studies.