6 Hong Kong hospitals | Between February 10 and March 20, 2020
Randomization (2:1) for a 14 day course of the following
Combination group: Combination of lopinavir 400 mg and ritonavir 100 mg every 12 hours | Ribavirin 400 mg every 12 hours | 3 doses of 8 million IU of interferon beta-1b on alternate days
Control group: Lopinavir 400 mg and ritonavir 100 mg every 12 h (control group)
Time for nasopharyngeal swab to be negative for SARS-CoV-2 (using RT-PCR)
127 patients were recruited
Combination group: 86
Control group: 41
Median time to symptom onset to start of study treatment: 5 days (IQR 3–7)
Combination group had a shorter time from treatment to negative swab result (p=0·0010)
Combination group: 7 days
Control group: 12 days
Hazard ratio (HR): 4·37 (95% CI, 1·86–10·24)
No difference between groups
Main side effects included limited nausea and diarrhea | Discontinuation of lopinavir–ritonavir in one patient (control group) because of biochemical hepatitis
No deaths in either group
In this phase 2 study, the authors conclude that
…early triple antiviral therapy was safe and superior to lopinavir–ritonavir alone in alleviating symptoms and shortening the duration of viral shedding and hospital stay in patients with mild to moderate COVID-19
Future clinical study of a double antiviral therapy with interferon beta-1b as a backbone is warranted
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