April 20, 2020
Two antiviral drugs that scientists hoped might prove effective at treating COVID-19 do not appear to provide patients with any meaningful benefits.
Lopinavir/ritonavir, currently used to treat HIV, and Arbidol, an influenza antiviral drug, don't appear to improve recovery from the coronavirus in adult patients with mild to moderate disease, according to a new study.
Interest in these drugs came from promising early vitro cell tests and clinical data from their use to treat SARS and MERS – diseases caused by two other coronaviruses. In February, the National Health Commission of China issued a guidance recommending these drugs as possible treatment candidates.
However, the most recent study, involving 86 patients, found the antivirals offered no obvious benefits when compared to supportive care. No differences were found in rates of fever reduction, cough alleviation or improvement of chest CT scan. Plus, the rate of positive-to-negative conversion of the coronavirus's nucleic acid was similar in all three groups.
"Our findings suggest that we need to cautiously consider before using these drugs," co-senior author Linghua Li, vice director of the Centre for Infectious Diseases of Guangzhou Eighth People's Hospital in Guangzhou, China said in a statement. "Researchers need to keep working to find a really effective antiviral regimen against COVID-19, but meanwhile, any conclusions about antiviral regimens need strict and scientific clinical trials and appropriate caution."
Additionally, some patients treated with the antivirals experienced adverse events. Twelve patients in the lopinavir/ritonavir study group and 5 in the arbidol group experienced side effects, including diarrhea, nausea and loss of appetite.
"We found that neither lopinavir/ritonavir nor arbidol could benefit clinical outcomes for patients and that they might bring some side effects," Li added. "And although the sample size is small, we believe it could still provide meaningful suggestions for proper application of lopinavir/ritonavir or arbidol for COVID-19."
Study findings were published last week in Med, a new medical journal published by Cell Press.
The drugs are among various treatments being tested as possible COVID-19 therapies. Others include nitric oxide – the gas that led to Viagra, plasma donations from COVID-19 survivors, and drugs like hydroxychloroquine and remdesivir.