Comparison of hydroxychloroquine, lopinavir/ritonavir, and standard of care in critically ill patients with SARS-CoV-2 pneumonia: an opportunistic retrospective analysis

{ 'indexed': {'date-parts': [[2024, 3, 28]], 'date-time': '2024-03-28T12:40:39Z', 'timestamp': 1711629639843}, 'reference-count': 22, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2020, 7, 11]], 'date-time': '2020-07-11T00:00:00Z', 'timestamp': 1594425600000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2020, 7, 11]], 'date-time': '2020-07-11T00:00:00Z', 'timestamp': 1594425600000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2020, 12]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' '<jats:title>Background</jats:title>\n' '<jats:p>The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak is ' 'spreading worldwide. To date, no specific treatment has convincingly demonstrated its ' 'efficacy. Hydroxychloroquine and lopinavir/ritonavir have potential interest, but virological ' 'and clinical data are scarce, especially in critically ill patients.</jats:p>\n' '</jats:sec><jats:sec>\n' '<jats:title>Methods</jats:title>\n' '<jats:p>The present report took the opportunity of compassionate use and successive drug ' 'shortages to compare the effects of two therapeutic options, lopinavir/ritonavir and ' 'hydroxychloroquine, as compared to standard of care only. The primary outcomes were treatment ' 'escalation (intubation, extra-corporeal membrane oxygenation support, or renal replacement ' 'therapy) after day 1 until day 28. Secondary outcomes included ventilator-free days at day ' '28, mortality at day 14 and day 28, treatment safety issues and changes in respiratory ' 'tracts, and plasma viral load (as estimated by cycle threshold value) between admission and ' 'day 7.</jats:p>\n' '</jats:sec><jats:sec>\n' '<jats:title>Results</jats:title>\n' '<jats:p>Eighty patients were treated during a 4-week period and included in the analysis: 22 ' '(28%) received standard of care only, 20 (25%) patients received lopinavir/ritonavir ' 'associated to standard of care, and 38 (47%) patients received hydroxychloroquine and ' 'standard of care. Baseline characteristics were well balanced between the 3 groups. Treatment ' 'escalation occurred in 9 (41%), 10 (50%), and 15 (39%) patients who received standard of care ' 'only, standard of care and lopinavir/ritonavir, and standard of care and hydroxychloroquine, ' 'respectively (<jats:italic>p</jats:italic>\u2009=\u20090.567). There was no significant ' 'difference between groups regarding the number of ventilator-free days at day 28 and ' 'mortality at day 14 and day 28. Finally, there was no significant change between groups in ' 'viral respiratory or plasma load between admission and day 7.</jats:p>\n' '</jats:sec><jats:sec>\n' '<jats:title>Conclusion</jats:title>\n' '<jats:p>In critically ill patients admitted for SARS-CoV-2-related pneumonia, no difference ' 'was found between hydroxychloroquine or lopinavir/ritonavir as compared to standard of care ' 'only on the proportion of patients who needed treatment escalation at day 28. Further ' 'randomized controlled trials are required to demonstrate whether these drugs may be useful in ' 'this context.</jats:p>\n' '</jats:sec>', 'DOI': '10.1186/s13054-020-03117-9', 'type': 'journal-article', 'created': {'date-parts': [[2020, 7, 11]], 'date-time': '2020-07-11T04:52:57Z', 'timestamp': 1594443177000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 36, 'title': 'Comparison of hydroxychloroquine, lopinavir/ritonavir, and standard of care in critically ill ' 'patients with SARS-CoV-2 pneumonia: an opportunistic retrospective analysis', 'prefix': '10.1186', 'volume': '24', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-5543-5074', 'authenticated-orcid': False, 'given': 'Marie', 'family': 'Lecronier', 'sequence': 'first', 'affiliation': []}, {'given': 'Alexandra', 'family': 'Beurton', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sonia', 'family': 'Burrel', 'sequence': 'additional', 'affiliation': []}, {'given': 'Luc', 'family': 'Haudebourg', 'sequence': 'additional', 'affiliation': []}, {'given': 'Robin', 'family': 'Deleris', 'sequence': 'additional', 'affiliation': []}, {'given': 'Julien', 'family': 'Le Marec', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sara', 'family': 'Virolle', 'sequence': 'additional', 'affiliation': []}, {'given': 'Safaa', 'family': 'Nemlaghi', 'sequence': 'additional', 'affiliation': []}, {'given': 'Côme', 'family': 'Bureau', 'sequence': 'additional', 'affiliation': []}, {'given': 'Pierre', 'family': 'Mora', 'sequence': 'additional', 'affiliation': []}, {'given': 'Martin', 'family': 'De Sarcus', 'sequence': 'additional', 'affiliation': []}, {'given': 'Olivier', 'family': 'Clovet', 'sequence': 'additional', 'affiliation': []}, {'given': 'Baptiste', 'family': 'Duceau', 'sequence': 'additional', 'affiliation': []}, {'given': 'Paul Henri', 'family': 'Grisot', 'sequence': 'additional', 'affiliation': []}, {'given': 'Marie Hélène', 'family': 'Pari', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jérémy', 'family': 'Arzoine', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ulrich', 'family': 'Clarac', 'sequence': 'additional', 'affiliation': []}, {'given': 'David', 'family': 'Boutolleau', 'sequence': 'additional', 'affiliation': []}, {'given': 'Mathieu', 'family': 'Raux', 'sequence': 'additional', 'affiliation': []}, {'given': 'Julie', 'family': 'Delemazure', 'sequence': 'additional', 'affiliation': []}, {'given': 'Morgane', 'family': 'Faure', 'sequence': 'additional', 'affiliation': []}, {'given': 'Maxens', 'family': 'Decavele', 'sequence': 'additional', 'affiliation': []}, {'given': 'Elise', 'family': 'Morawiec', 'sequence': 'additional', 'affiliation': []}, {'given': 'Julien', 'family': 'Mayaux', 'sequence': 'additional', 'affiliation': []}, {'given': 'Alexandre', 'family': 'Demoule', 'sequence': 'additional', 'affiliation': []}, {'given': 'Martin', 'family': 'Dres', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2020, 7, 11]]}, 'reference': [ { 'key': '3117_CR1', 'doi-asserted-by': 'publisher', 'first-page': '1708', 'DOI': '10.1056/NEJMoa2002032', 'volume': '382', 'author': 'W-J Guan', 'year': '2020', 'unstructured': 'Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. 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' 'https://www.recoverytrial.net/news/statement-from-the-chief-investigators-of-the-randomised-evaluation-of-covid-19-therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19; ' '2020.'}], 'container-title': 'Critical Care', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s13054-020-03117-9.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s13054-020-03117-9/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s13054-020-03117-9.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 7, 10]], 'date-time': '2021-07-10T23:41:55Z', 'timestamp': 1625960515000}, 'score': 1, 'resource': {'primary': {'URL': 'https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03117-9'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 7, 11]]}, 'references-count': 22, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2020, 12]]}}, 'alternative-id': ['3117'], 'URL': 'http://dx.doi.org/10.1186/s13054-020-03117-9', 'relation': {}, 'ISSN': ['1364-8535'], 'subject': ['Critical Care and Intensive Care Medicine'], 'container-title-short': 'Crit Care', 'published': {'date-parts': [[2020, 7, 11]]}, 'assertion': [ { 'value': '14 May 2020', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '29 June 2020', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '11 July 2020', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': 'The Research Ethics Committee of Sorbonne University approved the project (CER ' '2020-36). Oral information about this retrospective analysis was given to ' 'patients or relatives.', 'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'Not applicable', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'Martin Dres received fees from Lungpacer (expertise, lectures). A Demoule ' 'reports personal fees from Medtronic; grants, personal fees, and non-financial ' 'support from Philips; personal fees from Baxter; personal fees from Hamilton; ' 'personal fees and non-financial support from Fisher & Paykel; grants from ' 'French Ministry of Health; personal fees from Getinge; grants and personal fees ' 'from Respinor; and grants and non-financial support from Lungpacer, outside the ' 'submitted work. The other authors have no conflicts of interest to declare.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '418'}