1.Should Lopinavir/Ritonavir combination be used in the treatment of COVID-19?
Ian Theodore G. Cabaluna ; Michelle D. Villanueva
Acta Medica Philippina 2020;54(Rapid Reviews on COVID19):72-77
Background:
Lopinavir/Ritonavir is an oral combination agent being used to treat Human Immunodeficiency Virus. It was demonstrated to have clinical and in vitro activity against coronaviruses. There are no specific anti viral preparation or biologic agents currently recommended to treat Severe Acute Respiratory Syndrome Corona Virus
2(SARS-CoV-2) infection. There are no in-vitro studies published as well, for Lopinavir/ritonavir against SARS- CoV-2. However, recent case series and cohort studies showed earlier clinical improvement and shorter duration of viral shedding were noted especially if the combination drug is administered early in the course of the disease.
Objective:
The objective of this review is to search, retrieve, appraise and summarize existing studies and clinical trials regarding the efficacy and safety of Lopinavir/Ritonavir combination in the treatment of SARS Cov-2 infection. The evidenced based recommendations may be used as a guide by clinicians and practitioners in their current practice.
Methods:
Electronic databases were searched for evidences (Medline, CENTRAL, ISRCTN registry, ClinicalTrial. gov and Chinese Clinical Trial Registry) and articles were selected based on a pre-defined criteria according to population, intervention, outcome and study designs.
Results:
Two randomized controlled trials were included in this review. Lopinavir/ritonavir treatment did not significantly accelerate clinical improvement, reduce mortality, or shoten the viral RNA detectability in patients with serious COVID-19.
Conclusion
There is little evidence to conclude on the effectiveness of lopinavir/ritonavir in patients with COVID-19. More high-quality randomized controlled trials are needed.
Lopinavir
;
Ritonavir
;
COVID-19
2.Risk of COVID-19 outcomes among healthcare workers: Findings from the Philippine CORONA retrospective cohort study
Adrian I. Espiritu ; Carl Froilan D. Leochico ; Isabella E. Supnet ; Emilio Q. Villanueva III ; Marie Charmaine C. Sy ; Veeda Michelle M. Anlacan ; Roland Dominic G. Jamora
Acta Medica Philippina 2024;58(Early Access 2024):1-8
Objectives:
While many healthcare workers (HCWs) contracted COVID-19 during the pandemic, more information is needed to fully understand the potential for adverse health effects in this population segment. The aim of the present study is to examine the association between healthcare worker status and neurologic and clinical outcomes in COVID-19 infected inpatients.
Methods:
Using the nationwide database provided by the retrospective cohort Philippine CORONA study, we
extracted relevant data and performed a secondary analysis primarily focusing on the presentation and outcomes of healthcare workers. Propensity score matching in a 3:1 ratio was performed to match HCWs and non-HCWs. We performed multiple logistic and Cox regression analyses to determine the relationship between HCWs and COVID-19 clinical outcomes.
Results:
We included 3,362 patients infected with COVID-19; of which, 854 were HCWs. Among the HCWs, a total
of 31 (3.63%) and 45 (5.27%) had the primary outcomes of in-hospital mortality and respiratory failure, respectively. For both overall and 3:1 propensity-matched cohorts, being an HCW significantly decreased the odds of the following outcomes: severe/critical COVID-19 at nadir; in-hospital mortality; respiratory failure; intensive care unit admission; and hospital stay >14 days.
Conclusion
We found that being an HCW is not associated with worse neurologic and clinical outcomes among
patients hospitalized for COVID-19.
Health Personnel
;
COVID-19
;
SARS-CoV-2
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Cohort Studies