Lopinavir/ritonavir ve favipiravir ile tedavi edilen ağır olmayan COVID-19 pnömoni hastalarının karşılaştırılması

Öz

Amaç: Günümüzde COVID-19 için kanıtlanmış bir medikal tedavi yoktur. Çalışmamızda ağır seviyeli olmayan COVID-19 pnömoni hastalarında LPV/r ve FVR tedavilerinin etkinliğini değerlendirerek, LPV/r ile FVR ile tedavi edilen hastalar arasındaki klinik sonuçları karşılaştırmayı amaçladık. Yöntemler: Bu çalışma retrospektif bir kohort çalışmasıdır. Lopinavir/ritonavir ve FVR ile tedavi edilen ağır seviyeli olmayan COVID-19 pnömoni hastalarının verileri incelendi. Bulgular: 33'ü (%36,2) LPV/r ve 58'i (%63,8) FVR ile tedavi edilen, toplam 91 ağır seviyeli olmayan COVID-19 pnömoni hastası çalışmaya dahil edildi. LPV/r grubunun yaş ortalaması 53,1 (13), FVR grubunun yaş ortalaması 57,2 (17,4) idi (P=0,24). Her iki grup arasında komorbidite varlığı açısından istatiksel olarak anlamlı fark yoktu (P=0,06). FVR hastalarının LPV/r hastalarına göre radyolojik ağırlık skoru daha yüksekti ancak bu istatistiksel olarak anlamlı değildi (sırasıyla 8,67 (3,7) ve 7,66 (3,22), P=0,2). FVR hastalarının başvuru esnasındaki SpO2 seviyeleri LPV/r hastalarına göre daha düşük, CRP seviyeleri daha yüksekti (sırasıyla 92,22 (2,8) ve 97,87 (2,05), P<0,001, 75,42 (62) ve 45,42 (49,92), P=0,02). FVR hastalarında LPV /r hastalarına göre ateşin düşme süresi daha kısa idi (sırasıyla 2,7 (0,9) ve 4 (1), P<0,001). FVR kullanan hastalarda tedavi sonrasında LPV/r kullanan hastalara göre Nötrofil, Lenfosit, N/L oranı ve D-Dimer seviyelerinin daha fazla düştüğü saptandı (sırasıyla P=0,01, <0,001, 0,001, <0,001). Sonuç: FVR kullanan hastaların, başvuru esnasında daha düşük oksijen saturasyonlarına, daha yaygın radyolojik tutulumlarına ve daha yüksek CRP seviyelerine sahip olmasına rağmen LPV/r kullanan hastalara göre laboratuvar parametrelerinin düzelmesinde ve ateşin kontrol altına alınmasında daha etkili olduğunu saptadık. COVID-19 hastalarında LPV/r ve FVR tedavilerinin etkinliği üzerine daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• COVID-19
• Ağır olmayan pnomoni
• Favipiravir
• Lopinavir/ritonavir

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 D-Dimer 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.

Keywords

• COVID 19
• non severe pneumonia
• lopinavir ritonavir
• favipiravir

Kaynakça

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