Use of Darunavir-Cobicistat as a Treatment Option for Critically Ill Patients with SARS-CoV-2 Infection
Eun Jin Kim, Sun Ha Choi, Jae Seok Park, Yong Shik Kwon, Jaehee Lee, Yeonjae Kim, Shin Yup Lee, MD Eun Young Choi
Yonsei Medical Journal, doi:10.3349/ymj.2020.61.9.826
On March 11, 2020, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) a pandemic. Until May 20, 2020, there were more than 4.9 million reported COVID-19 cases and 324869 deaths across more than 200 countries. Currently, there are no specific therapeutic agents for treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Potential drugs for treating COVID-19 include human immunodeficiency virus (HIV) type 1 aspartate protease inhibitors, such as lopinavir and darunavir, which have been shown to inhibit SARS-CoV in vitro, the cause of SARS in humans. [1] [2] [3] [4] Cobicistat-boosted darunavir is a boosted protease inhibitor in a fixed-dose combination that is approved for use in treating HIV type 1 infection. 5, 6 Drug efficacy evaluation in cell models in vitro have revealed that darunavir is active against SARS-CoV-2. 2 At present, however, there are no clinical data on the use of these drugs for COVID-19. Cobicistat-boosted darunavir is stable as a suspension, 7 so it was considered to be suitable for administration as a nasogastric tube to critical ill patients. Here, we evaluated the effects of darunavir-cobicistat on the clinical outcomes of critically ill patients with COVID-19 using a risk stratification model that adjusted for potential differences between the darunavir-cobicistat treated and non-darunavir-cobicistat treated individuals. We retrospectively reviewed the medical records of all adults with laboratory-confirmed SARS-CoV-2 infection who were subsequently admitted to an intensive care unit (ICU) at one of the
AUTHOR CONTRIBUTIONS Conceptualization: Eun Young Choi. Data curation: all authors. Formal analysis: Eun Jin Kim and Sun Ha Choi.
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