Lopinavir/ritonavir is associated with pneumonia resolution in COVID-19 patients with influenza coinfection: a retrospective matched-pair cohort study

https://doi.org/10.1002/jmv.26260

This is a retrospective study of 128 hospitalized patients with COVID-19 pneumonia. All patients were positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive by nucleic acid detection. 64 cases were co-infected with influenza A/B and the other 64 were influenza negative, matched by age, sex, and days from onset of symptoms. Among the 64 co-infected patients, 54 (84.4%) were co-infected with influenza A, and 10 (15.6%) with influenza B. The median duration of viral shedding time from admission was longer for patients with influenza coinfection (17.0 days) than for those without influenza coinfection (12.0 days) (P<0.001). The multivariable Cox proportional hazards model showed that the hazard ratio HR of resolution in lung involvement was 1.878 (P=0.020) for patients administered lopinavir/ritonavir, compared with those not administered lopinavir/ritonavir (95% confidence interval (CI) 1.103, 3.196). Among influenza co-infected patients, those treated with lopinavir/ritonavir exhibited faster pneumonia resolution within two weeks after symptom onset (37% vs 1%, P=0.001). There was no difference in lung involvement between influenza co-infected and non-infected groups. Lopinavir/ritonavir eliminated the difference of lung involvement between influenza co-infected and non-infected groups, indicating that lopinavir/ritonavir is associated with pneumonia resolution in COVID-19.

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