Comparison of the Efficacy of Sofosbuvir and Kaletra on the Outcome of COVID-19. Is Sofosbuvir A Potential Treatment For COVID-19?
Novelty in Biomedicine,
Vol. 9 No. 1 (2021),
8 Bahman 2021
,
Page 17-23
https://doi.org/10.22037/nbm.vi.31956
Abstract
Background: The COVID-19 is a family of large enveloped non-segmented positive-sense RNA viruses which was first reported in December 2019 in Wuhan, China with a cluster of unexplained pneumonia. Although various medications have been tried to manage the COVID-19 pandemic, there is no exclusive medication or vaccine so far. In this study, we aimed to focus on the effectiveness of Hydroxychloroquine + Kaletra (lopinavir/ritonavir) versus Hydroxychloroquine + Sofosbuvir in patients hospitalized with COVID-19 to given the urgent need for an effective drug against SARS-CoV-2 in the current pandemic context.Materials and Methods: Fifty-four eligible patients with moderate to severe COVID-19 symptoms, according to the WHO criteria entered the study. Patients were randomized into two treatment groups. Thirty-two patients received Hydroxicholoroquine (400 mg stat) and Kaletra (400/100 mg q 12 h) as a control group (group A) and the trial group of 22 patients, received Hydroxicholoroquine (200 mg q 12 h) plus Sofosbuvir (400 mg daily) (group B) for a period of 7 to 14 days. Eventually, collected data included demographic characteristics, underlying diseases, clinical symptoms, laboratory data, and mortality were analyzed.
Results: There was no significant difference in age, sex, and underlying diseases between the two groups. There was no significant statistical difference between the two groups on the seventh day of treatment in terms of cough relief, leukocyte count, and improvement of lymphopenia however in terms of the time of defervescence of fever, there was a significant difference between the two groups.
Conclusion: Therefore, it can be said that our study is one of the first studies in the world to evaluate the effectiveness of sofosbuvir in the treatment of patients with COVID-19. According to our results, although Kaletra was assumed as an effective therapy, its superiority over Sofosbuvir was confined to the earlier effervescence of the 7-day fever and sofosbuvir can be used as an effective treatment, especially in patients with underlying heart disease who are at risk for arrhythmias with Kaletra.
- COVID-19, Sofosbuvir, Lopinavir/ritonavir, Treatment
How to Cite
References
2. Lu H. Drug treatment options for the 2019-new coronavirus (2019-nCoV). Biosci Trends. 2020.DOI:10.5582/bst.2020.01020
3. Elfiky AA. Anti-HCV, nucleotide inhibitors, repurposing against COVID-19. Life Sci [Internet]. 2020 May;248:117477. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0024320520302253
4. Zhou D, Dai S-M, Tong Q. COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression. J Antimicrob Chemother [Internet]. 2020 Jul 1;75(7):1667–70. Available from: https://academic.oup.com/jac/article/75/7/1667/5810487
5. Pang J, Wang MX, Ang IYH, Tan SHX, Lewis RF, Chen JI-P, et al. Potential Rapid Diagnostics, Vaccine and Therapeutics for 2019 Novel Coronavirus (2019-nCoV): A Systematic Review. J Clin Med [Internet]. 2020 Feb 26;9(3):623. Available from: https://www.mdpi.com/2077-0383/9/3/623
6. Phan LT, Nguyen T V., Luong QC, Nguyen T V., Nguyen HT, Le HQ, et al. Importation and Human-to-Human Transmission of a Novel Coronavirus in Vietnam. N Engl J Med [Internet]. 2020 Feb 27;382(9):872–4. Available from: http://www.nejm.org/doi/10.1056/NEJMc2001272
7. Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MUG, Khan K. Pneumonia of unknown aetiology in Wuhan, China: potential for international spread via commercial air travel. J Travel Med [Internet]. 2020 Mar 13;27(2). Available from: https://academic.oup.com/jtm/article/doi/10.1093/jtm/taaa008/5704418
8. Organization WH. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: interim guidance, 28 January 2020 [Internet]. Geneva PP - Geneva: World Health Organization; 2020. Available from: https://apps.who.int/iris/handle/10665/330893
9. CDC. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) [Internet]. 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
10. FDA. FDA site [Internet]. 2020. Available from: https://www.fda.gov/emergency-preparedness-and-response/mcmissues/coronavirusdisease-2019-covid-19
11. Lotteau V, Teyton L, Peleraux A, Nilsson T, Karlsson L, Schmid SL, et al. Intracellular transport of class II MHC molecules directed by invariant chain. Nature [Internet]. 1990 Dec;348(6302):600–5. Available from: http://www.nature.com/articles/348600a0
12. Wu S-F, Chang C-B, Hsu J-M, Lu M-C, Lai N-S, Li C, et al. Hydroxychloroquine inhibits CD154 expression in CD4+ T lymphocytes of systemic lupus erythematosus through NFAT, but not STAT5, signaling. Arthritis Res Ther [Internet]. 2017 Dec 9;19(1):183. Available from: http://arthritis-research.biomedcentral.com/articles/10.1186/s13075-017-1393-y
13. van den Borne BE, Dijkmans BA, de Rooij HH, le Cessie S, Verweij CL. Chloroquine and hydroxychloroquine equally affect tumor necrosis factor-alpha, interleukin 6, and interferon-gamma production by peripheral blood mononuclear cells. J Rheumatol. 1997 Jan;24(1):55–60.
14. Kužnik A, Benčina M, Švajger U, Jeras M, Rozman B, Jerala R. Mechanism of Endosomal TLR Inhibition by Antimalarial Drugs and Imidazoquinolines. J Immunol [Internet]. 2011 Apr 15;186(8):4794–804. Available from: http://www.jimmunol.org/lookup/doi/10.4049/jimmunol.1000702
15. Vollmer J, Tluk S, Schmitz C, Hamm S, Jurk M, Forsbach A, et al. Immune stimulation mediated by autoantigen binding sites within small nuclear RNAs involves Toll-like receptors 7 and 8. J Exp Med [Internet]. 2005 Dec 5;202(11):1575–85. Available from: https://rupress.org/jem/article/202/11/1575/52674/Immune-stimulation-mediated-by-autoantigen-binding
16. An J, Woodward JJ, Sasaki T, Minie M, Elkon KB. Cutting edge: Antimalarial drugs inhibit IFN-β production through blockade of cyclic GMP-AMP synthase-DNA interaction. J Immunol. 2015 May;194(9):4089–93.
17. Zhong H, Wang Y, Zhang Z-L, Liu Y-X, Le K-J, Cui M, et al. Efficacy and safety of current therapeutic options for COVID-19 - lessons to be learnt from SARS and MERS epidemic: A systematic review and meta-analysis. Pharmacol Res [Internet]. 2020 Jul;157:104872. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1043661820311804
18. Dorward J, Gbinigie K. Lopinavir/ritonavir: A rapid review of effectiveness in COVID-19 [Internet]. 2020. Available from: https://www.cebm.net/covid-19/lopinavir-ritonavir-a-rapid-review-of-the-evidence-for-effectiveness-in-treating-covid/
19. Chu CM. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax [Internet]. 2004 Mar 1;59(3):252–6. Available from: http://thorax.bmj.com/cgi/doi/10.1136/thorax.2003.012658
20. Chan KS, Lai ST, Chu CM, Tsui E, Tam CY, Wong MML, et al. Treatment of severe acute respiratory syndrome with lopinavir/ritonavir: a multicentre retrospective matched cohort study. Hong Kong Med J = Xianggang yi xue za zhi [Internet]. 2003 Dec;9(6):399–406. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14660806
21. Klement-Frutos E, Burrel S, Peytavin G, Marot S, Lê MP, Godefroy N, et al. Early administration of ritonavir-boosted lopinavir could prevent severe COVID-19. J Infect [Internet]. 2020 May; Available from: https://linkinghub.elsevier.com/retrieve/pii/S0163445320303182
22. Hung IF-N, Lung K-C, Tso EY-K, Liu R, Chung TW-H, Chu M-Y, et al. Triple combination of interferon beta-1b, lopinavir–ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. Lancet [Internet]. 2020 May;395(10238):1695–704. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0140673620310424
23. Ballou A. Mayo Clinic Preparing to Commence Phase II FDA Clinical Trial for the Treatment of COVID-19 with VicromaxTM [Internet]. BioSig Technologies, Inc. 2020. Available from: https://www.biosig.com/news-media/press-releases/detail/188/mayo-clinic-preparing-to-commence-phase-ii-fda-clinical
24. FirstWave Bio. FirstWave Bio to Initiate Phase 2a/2b Study of FW-1022, a Proprietary Form of Niclosamide, to Treat COVID-19 [Internet]. 2020. Available from: https://pipelinereview.com/index.php/2020041074293/Small-Molecules/FirstWave-Bio-to-Initiate-Phase-2a/2b-Study-of-FW-1022-a-Proprietary-Form-of-Niclosamide-to-Treat-COVID-19.html
25. Elfiky AA. Novel guanosine derivatives against Zika virus polymerase in silico. J Med Virol [Internet]. 2020 Jan 29;92(1):11–6. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.25573
26. Sayad B, Sobhani M, Khodarahmi R. Sofosbuvir as Repurposed Antiviral Drug Against COVID-19: Why Were We Convinced to Evaluate the Drug in a Registered/Approved Clinical Trial? Arch Med Res [Internet]. 2020 Apr; Available from: https://linkinghub.elsevier.com/retrieve/pii/S0188440920305518
27. Mobarak S. Comparison of the effect of two drugs Daclatasvir + Sofosbuvir and Ribavirin in COVID-19 patients with severe symptoms [Internet]. 2020. Available from: https://www.irct.ir/trial/46713
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