Chloroquine, arbidol (umifenovir) or lopinavir/ritonavir as the antiviral monotherapy for COVID-19 patients: a retrospective cohort study

Huang, Hui; Guan, Lili; Yang, Yuqiong; Grange, Jehane Michael Le; Tang, Guoyan; Xu, Yifan; Yuan, Jingjing; Lin, Changqing; Xue, Mingshan; Zhang, Xinlu; Chen, Rongchang; Zhou, Luqian; Huang, Wenjie

doi:10.21203/rs.3.rs-24667/v1

Cited by 14 publications

(15 citation statements)

References 10 publications

(12 reference statements)

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“…Of the 79 papers included, 58 studies were done in China (appendix pp 1-4). 2,10-12, [14][15][16][17][19][20][21][23][24][25][26][27][28][35][36][37][38][39][40][41]43,44,[48][49][50][52][53][54][55][56][57][58][59][60][61][62][63][65][66][67][68][69][70][71][72][73][75][76][77][78][79][80]…”

Section: Resultsmentioning

confidence: 99%

“…350 articles were retrieved for full-text review. After reviewing the eligibility criteria, 79 studies (5340 individuals) on SARS-CoV-2, 2 , 3 , 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ,…”

Section: Resultsmentioning

confidence: 99%

“… 2 , 10 , 11 , 12 , 14 , 15 , 16 , 17 , 19 , 20 , 21 , 23 , 24 , 25 , 26 , 27 , 28 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 43 , 44 , 48 , 49 , 50 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 73 studies included only patients who were admitted to hospital. 3 , 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , …”

Section: Resultsmentioning

confidence: 99%

“…Fang et al (2020) 29 Cai et al (2020) 24 Hu et al (2020) 35 Kim et al (2020) 4 Le et al (2020) 57 Lo et al (2020) 68 Ling et al (2020) 45 Qian et al (2020) 71 Wu et al (2020) 38 Xiao et al (2020) 43 Xu et al (2020) 36 Xu et al (2020) 12 Yongchen et al (2020) 34 Young et al (2020) 20 Zhou et al (2020) 40 Zhou et al (2020) 33 Zhu et al (2020) 82 Sakurai et al (2020) 41 To et al (2020) 58 Huang et al (2020) 49 Liang et al (2020) 47 Shi et al (2020) 31 Talmy et al (2020) 42 Chen et al (2020) 26 Hu et al (2020) 53 Song et al (2020) 75 Yang et al (2020) 54 Wu et al (2020) 79 Zhang et al (2020) 22 Fu et al (2020) 64 Tan et al (2020) 17 Kujawski et al (2020) 16 Yan et al (2020) 37 Yang et al (2020) 81 Xu et al (2020) 80 Huang et al (2020) 21 Chen et al (2020) 25 Chang et al (2020) 61 Li et al (2020) 66 Pongpirul et al (2020) 70 Tan et al (2020) 10 Wang et al (2020) 77 Zha et al (2020) 46 longer duration of viral shedding in patients with severe illness than in those with non-severe illness,…”

Section: Sementioning

confidence: 99%

“…48 None of the antiviral regimens (chloroquine, oseltamivir, arbidol, and lopinavir-ritonavir) indepen dently improved viral RNA clearance. 26,49 In a retrospective study of 284 patients, lopinavir-ritonavir use was associated with delayed viral clearance even after adjusting for confounders. 26 12 studies reported viral load dynamics or duration of viral shedding among individuals with asymptomatic SARS-CoV-2 infection (table 2); two demonstrated lower viral loads among asymptomatic individuals than among symptomatic individuals, 8,50 and four found similar initial viral loads.…”

Section: Overallmentioning

confidence: 99%

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SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis

et al. 2021

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Background Viral load kinetics and duration of viral shedding are important determinants for disease transmission. We aimed to characterise viral load dynamics, duration of viral RNA shedding, and viable virus shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in various body fluids, and to compare SARS-CoV-2, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV) viral dynamics. Methods In this systematic review and meta-analysis, we searched databases, including MEDLINE, Embase, Europe PubMed Central, medRxiv, and bioRxiv, and the grey literature, for research articles published between Jan 1, 2003, and June 6, 2020. We included case series (with five or more participants), cohort studies, and randomised controlled trials that reported SARS-CoV-2, SARS-CoV, or MERS-CoV infection, and reported viral load kinetics, duration of viral shedding, or viable virus. Two authors independently extracted data from published studies, or contacted authors to request data, and assessed study quality and risk of bias using the Joanna Briggs Institute Critical Appraisal Checklist tools. We calculated the mean duration of viral shedding and 95% CIs for every study included and applied the random-effects model to estimate a pooled effect size. We used a weighted meta-regression with an unrestricted maximum likelihood model to assess the effect of potential moderators on the pooled effect size. This study is registered with PROSPERO, CRD42020181914. Findings 79 studies (5340 individuals) on SARS-CoV-2, eight studies (1858 individuals) on SARS-CoV, and 11 studies (799 individuals) on MERS-CoV were included. Mean duration of SARS-CoV-2 RNA shedding was 17•0 days (95% CI 15•5-18•6; 43 studies, 3229 individuals) in upper respiratory tract, 14•6 days (9•3-20•0; seven studies, 260 individuals) in lower respiratory tract, 17•2 days (14•4-20•1; 13 studies, 586 individuals) in stool, and 16•6 days (3•6-29•7; two studies, 108 individuals) in serum samples. Maximum shedding duration was 83 days in the upper respiratory tract, 59 days in the lower respiratory tract, 126 days in stools, and 60 days in serum. Pooled mean SARS-CoV-2 shedding duration was positively associated with age (slope 0•304 [95% CI 0•115-0•493]; p=0•0016). No study detected live virus beyond day 9 of illness, despite persistently high viral loads, which were inferred from cycle threshold values. SARS-CoV-2 viral load in the upper respiratory tract appeared to peak in the first week of illness, whereas that of SARS-CoV peaked at days 10-14 and that of MERS-CoV peaked at days 7-10. Interpretation Although SARS-CoV-2 RNA shedding in respiratory and stool samples can be prolonged, duration of viable virus is relatively short-lived. SARS-CoV-2 titres in the upper respiratory tract peak in the first week of illness. Early case finding and isolation, and public education on the spectrum of illness and period of infectiousness are key to the effective containment of SARS-CoV-2. Funding None.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Sementioning

confidence: 99%

Section: Overallmentioning

confidence: 99%

See 3 more Smart Citations

SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis

et al. 2021

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Efficacy and safety of arbidol (umifenovir) in patients with COVID‐19: A systematic review and meta‐analysis

Amani

Zareei

et al. 2021

Immunity Inflam & Disease

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Objective To provide the latest evidence for the efficacy and safety of arbidol (umifenovir) in COVID‐19 treatment. Methods A literature systematic search was carried out in PubMed, Cochrane Library, Embase, and medRxiv up to May 2021. The Cochrane risk of bias tool and Newcastle–Ottawa scale were used to assess the quality of included studies. Meta‐analysis was performed using RevMan 5.3. Results Sixteen studies were met the inclusion criteria. No significant difference was observed between arbidol and non‐antiviral treatment groups neither for primary outcomes, including the negative rate of PCR (NR‐PCR) on Day 7 (risk ratio [RR]: 0.94; 95% confidence interval (CI): 0.78–1.14) and Day 14 (RR: 1.10; 95% CI: 0.96–1.25), and PCR negative conversion time (PCR‐NCT; mean difference [MD]: 0.74; 95% CI: −0.87 to 2.34), nor secondary outcomes ( p > .05). However, arbidol was associated with higher adverse events (RR: 2.24; 95% CI: 1.06–4.73). Compared with lopinavir/ritonavir, arbidol showed better efficacy for primary outcomes ( p < .05). Adding arbidol to lopinavir/ritonavir also led to better efficacy in terms of NR‐PCR on Day 7 and PCR‐NCT ( p < .05). There was no significant difference between arbidol and chloroquine in primary outcomes ( p > .05). No remarkable therapeutic effect was observed between arbidol and other agents ( p > .05). Conclusion The present meta‐analysis showed no significant benefit of using arbidol compared with non‐antiviral treatment or other therapeutic agents against COVID‐19 disease. High‐quality studies are needed to establish the efficacy and safety of arbidol for COVID‐19.

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Ongoing Clinical Trials and the Potential Therapeutics for COVID-19 Treatment

et al. 2021

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Chloroquine, arbidol (umifenovir) or lopinavir/ritonavir as the antiviral monotherapy for COVID-19 patients: a retrospective cohort study

Cited by 14 publications

References 10 publications

SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis

SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis

Efficacy and safety of arbidol (umifenovir) in patients with COVID‐19: A systematic review and meta‐analysis

Ongoing Clinical Trials and the Potential Therapeutics for COVID-19 Treatment

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