Efficacy of Lopinavir Combined with Doxycycline for Treatment of
COVID-19: A Retrospective Comparison of Two Cohorts
Abstract
Introduction: Though there is currently no approved treatment for
COVID-19, potential medications include lopinavir and doxycycline.
Lopinavir is a broad-spectrum protease inhibitor successfully used
during the SARS outbreak. Doxycycline is an antibiotic with
immunomodulatory effects, which successfully treats dengue hemorrhagic
fever. Comparing lopinavir combined with doxycycline with other commonly
implemented COVID-19 treatment regimens is of medical significance.
Methods: We conducted a retrospective study comparing two cohorts. One
cohort strictly adhered to a treatment protocol of lopinavir combined
with doxycycline (Lop/Dox), while the other cohort (Others) applied
protocols based on combinations of favipiravir, hydroxychloroquine, and
azithromycin. The outcomes evaluated were death from coronavirus and
intubation. Results: During the study period, 161 and 114 patients were
followed in the Lop/Dox cohort and the Others cohort, respectively. The
Lop/Dox cohort was older and had lower O2 saturation at admission. The
proportion of patients needing intubation did not differ between the
cohorts (Lop/Dox, 15∙5%; Others, 16∙7%). The overall fatality rate
likewise did not differ (12∙4%) in Lop/Dox and 8∙7% in the Others
cohort). Older age and elapsed time between the onset of symptoms and
hospitalization, O2 saturation at admission, and the lymphocyte to white
blood cell ratio were independent risk factors for poor outcomes of the
illness. Conclusion: This study showed that lopinavir plus doxycycline
therapy is an effective treatment amongst moderate to severe COVID-19
patients.