Many hospitals have reportedly seen improvement with use of HIV drugs in patients with coronavirus. As many such reports surfaced, doctors in Wuhan, China conducted a study to test the efficacy of Anti-HIV drugs against coronavirus. At the end of the study, they concluded that drugs which have been successful in suppressing HIV have little to no effect on coronavirus. The team of doctors recently published their findings from their clinical trial in The New England Journal of Medicine.
The use of anti-HIV drugs for treating coronavirus had a sound theoretical basis. Both coronavirus and HIV seemed to require protease to become an active pathogen. Therefore, using drugs such as lopinavir and ritonavir which are protease inhibitors seemed theoretically correct. Protease inhibitors have been found to effective in treating HIV by its enzyme inhibitory action, according to prior clinical studies on HIV and protease inhibitors. In order to confirm the theory, doctors from Wuhan had decided to conduct a clinical trial.
Participants: 199 confirmed cases of COVID-19. All 199 cases required intensive care.
Methodology: The 199 patients were divided into two groups. One group received intensive care with oxygen supplementation and any required resuscitative measures. The second group received all the care of the first group plus Lopinavir and Ritonavir. A total of 94 patients were included in the second group.
Conclusion: No significant improvement was seen in the second group of patients in comparison to the first group. As the clinical trial involved only advanced cases and involved a relatively small number of patients, the findings may not be very meaningful. Shortening of the symptomatic period was seen by one day in patients who received the protease inhibitor within 12 days of onset of symptoms.
Since all the patients in the clinical trial were in advanced stages, minimal or no improvement with anti-viral drugs can be expected. In advanced stages, the virus has already replicated to a significant number affecting the respiratory system extensively. It is possible that the protease inhibitor may be more effective in milder cases or cases in the earlier stages of the infection.