This study purports to find no benefit to lopinavir–ritonavir treatment:
But this study suggests lopinavir–ritonavir is standard practice in China and finds no benefit to hydroxychloroquine over lopinavir–ritonavir:
But from the latter:
The study involved just 30 patients. Of the 15 patients given the malaria drug, 13 tested negative for the coronavirus after a week of treatment. Of the 15 patients who didn’t get hydroxychloroquine [(but got lopinavir–ritonavir)], 14 tested negative for the virus.
Those are insane numbers. Are they suggesting that there’s more than a 90% cure rate with both?
The first study had a very different result:
The percentage of patients with detectable viral RNA for SARS-CoV-2 was similar in the lopinavir–ritonavir group and the standard-care group on any sampling day (day 5, 34.5% vs. 32.9%; day 10, 50.0% vs. 48.6%; day 14, 55.2% vs. 57.1%; day 21, 58.6% vs. 58.6%; and day 28, 60.3% vs. 58.6%) (Table S2).
Much lower overall improvement apparently.
But the first study did show very worthwhile benefits:
Patients in the lopinavir–ritonavir group had a shorter stay in the intensive care unit (ICU) than those in the standard-care group (median, 6 days vs. 11 days; difference, −5 days; 95% CI, −9 to 0), and the duration from randomization to hospital discharge was numerically shorter (median, 12 days vs. 14 days; difference, 1 day; 95% CI, 0 to 3). In addition, the percentage of patients with clinical improvement at day 14 was higher in the lopinavir–ritonavir group than in the standard-care group (45.5% vs. 30.0%; difference, 15.5 percentage points; 95% CI, 2.2 to 28.8) (Fig. S5). There were no significant differences for other outcomes such as duration of oxygen therapy, duration of hospitalization, and time from randomization to death.
A 40% reduction in ICU time alone is presumably worth the price of admission. That may be why the Chinese made it standard treatment.
Thus, the further question is begged of a combination of both treatments or both plus azithromycin as in the French study’s combo with hydroxychloroquine.