J Med Virol. 2021 Jul 13. doi: 10.1002/jmv.27195. Online ahead of print.
The purpose of this study was to compare the effectiveness of Atazanavir/Ritonavir/Dolutegravir/Hydroxychloroquine and Lopinavir/Ritonavir/Hydroxychloroquine treatment regimens in COVID-19 patients based on clinical and laboratory parameters. We prospectively evaluated the clinical and laboratory outcomes of 62 moderate to severe COVID-19 patients during a 10-day treatment plan. Patients were randomly assigned to either KH (receiving Lopinavir/Ritonavir (Kaletra) plus Hydroxychloroquine) or ADH (receiving Atazanavir/Ritonavir, Dolutegravir and Hydroxychloroquine) groups. During this period, clinical and laboratory parameters and outcomes such as Intensive Care Unit (ICU) admission or mortality rate were recorded. Compared to KH group, after the treatment period, patients in ADH group had higher Activated Partial Thromboplastin Time (aPTT) (12, (95%CI: 6.97, 17.06) p=<0.01), International Normalized Ratio (INR) (0.17, (95%CI: 0.07, 0.27) p=<0.01) and lower C-reactive protein (CRP) (-14.29, (95%CI: -26.87, -1.71) p=0.03) and Potassium (-0.53, (95%CI: -1.03, -0.03) p=0.04) values. Moreover, a higher number of patients in KH group needed invasive ventilation (6 (20%) vs 1 (3.1%), p=0.05) and antibiotic administration (27 (90%) vs 21(65.6), p=0.02) during hospitalization while patients in ADH group needed more corticosteroid administration (9 (28.1%) vs 2 (6.7%), p=0.03). There was no difference in mortality rate, ICU admission rate and hospitalization period between the study groups. Our results suggest that Atazanavir/Dolutegravir treatment regimen may result in a less severe disease course compared to the Lopinavir/Ritonavir treatment regimen and can be considered as an alternative treatment option besides standard care. However, to confirm our results, larger-scale studies are recommended. This article is protected by copyright. All rights reserved.