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Article: Treatment of severe acute respiratory syndrome with lopinavir/ritonavir: A multicentre retrospective matched cohort study

TitleTreatment of severe acute respiratory syndrome with lopinavir/ritonavir: A multicentre retrospective matched cohort study
Authors
KeywordsCoronavirus
Protease inhibitors
SARS virus
Treatment outcome
Issue Date2003
PublisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org/resources/supp.html
Citation
Hong Kong Medical Journal, 2003, v. 9 n. 6, p. 399-406 How to Cite?
AbstractObjectives. To investigate the possible benefits and adverse effects of the addition of lopinavir/ritonavir to a standard treatment protocol for the treatment of severe acute respiratory syndrome. Design. Retrospective matched cohort study. Setting. Four acute regional hospitals in Hong Kong. Patients and methods. Seventy-five patients with severe acute respiratory syndrome treated with lopinavir/ritonavir in addition to a standard treatment protocol adopted by the Hospital Authority were matched with controls retrieved from the Hospital Authority severe acute respiratory syndrome central database. Matching was done with respect to age, sex, the presence of co-morbidities, lactate dehydrogenase level and the use of pulse steroid therapy. The 75 patients treated with lopinavir/ritonavir were divided into two subgroups for analysis: lopinavir/ritonavir as initial treatment, and lopinavir/ritonavir as rescue therapy. These groups were compared with matched cohorts of 634 and 343 patients, respectively. Outcomes including overall death rate, oxygen desaturation, intubation rate, and use of pulse methylprednisolone were reviewed. Results. The addition of lopinavir/ritonavir as initial treatment was associated with a reduction in the overall death rate (2.3%) and intubation rate (0%), when compared with a matched cohort who received standard treatment (15.6% and 11.0% respectively, P<0.05) and a lower rate of use of methylprednisolone at a lower mean dose. The subgroup who had received lopinavir/ritonavir as rescue therapy, showed no difference in overall death rate and rates of oxygen desaturation and intubation compared with the matched cohort, and received a higher mean dose of methylprednisolone. Conclusion. The addition of lopinavir/ritonavir to a standard treatment protocol as an initial treatment for severe acute respiratory syndrome appeared to be associated with improved clinical outcome. A randomised double-blind placebo-controlled trial is recommended during future epidemics to further evaluate this treatment.
Persistent Identifierhttp://hdl.handle.net/10722/53428
ISSN
2021 Impact Factor: 1.256
2020 SCImago Journal Rankings: 0.357
References

 

DC FieldValueLanguage
dc.contributor.authorChan, KSen_HK
dc.contributor.authorLai, STen_HK
dc.contributor.authorChu, CMen_HK
dc.contributor.authorTsui, Een_HK
dc.contributor.authorTam, CYen_HK
dc.contributor.authorWong, MMLen_HK
dc.contributor.authorTse, MWen_HK
dc.contributor.authorQue, TLen_HK
dc.contributor.authorPeiris, JSMen_HK
dc.contributor.authorSung, Jen_HK
dc.contributor.authorWong, VCWen_HK
dc.contributor.authorYuen, KYen_HK
dc.date.accessioned2009-04-03T07:19:30Z-
dc.date.available2009-04-03T07:19:30Z-
dc.date.issued2003en_HK
dc.identifier.citationHong Kong Medical Journal, 2003, v. 9 n. 6, p. 399-406en_HK
dc.identifier.issn1024-2708en_HK
dc.identifier.urihttp://hdl.handle.net/10722/53428-
dc.description.abstractObjectives. To investigate the possible benefits and adverse effects of the addition of lopinavir/ritonavir to a standard treatment protocol for the treatment of severe acute respiratory syndrome. Design. Retrospective matched cohort study. Setting. Four acute regional hospitals in Hong Kong. Patients and methods. Seventy-five patients with severe acute respiratory syndrome treated with lopinavir/ritonavir in addition to a standard treatment protocol adopted by the Hospital Authority were matched with controls retrieved from the Hospital Authority severe acute respiratory syndrome central database. Matching was done with respect to age, sex, the presence of co-morbidities, lactate dehydrogenase level and the use of pulse steroid therapy. The 75 patients treated with lopinavir/ritonavir were divided into two subgroups for analysis: lopinavir/ritonavir as initial treatment, and lopinavir/ritonavir as rescue therapy. These groups were compared with matched cohorts of 634 and 343 patients, respectively. Outcomes including overall death rate, oxygen desaturation, intubation rate, and use of pulse methylprednisolone were reviewed. Results. The addition of lopinavir/ritonavir as initial treatment was associated with a reduction in the overall death rate (2.3%) and intubation rate (0%), when compared with a matched cohort who received standard treatment (15.6% and 11.0% respectively, P<0.05) and a lower rate of use of methylprednisolone at a lower mean dose. The subgroup who had received lopinavir/ritonavir as rescue therapy, showed no difference in overall death rate and rates of oxygen desaturation and intubation compared with the matched cohort, and received a higher mean dose of methylprednisolone. Conclusion. The addition of lopinavir/ritonavir to a standard treatment protocol as an initial treatment for severe acute respiratory syndrome appeared to be associated with improved clinical outcome. A randomised double-blind placebo-controlled trial is recommended during future epidemics to further evaluate this treatment.en_HK
dc.languageengen_HK
dc.publisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org/resources/supp.htmlen_HK
dc.relation.ispartofHong Kong Medical Journalen_HK
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Medical Association.en_HK
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCoronavirusen_HK
dc.subjectProtease inhibitorsen_HK
dc.subjectSARS virusen_HK
dc.subjectTreatment outcomeen_HK
dc.subject.meshAntiviral Agents - therapeutic useen_HK
dc.subject.meshPyrimidinones - therapeutic useen_HK
dc.subject.meshRitonavir - therapeutic useen_HK
dc.subject.meshSevere Acute Respiratory Syndrome - drug therapyen_HK
dc.subject.meshDrug Therapy, Combinationen_HK
dc.titleTreatment of severe acute respiratory syndrome with lopinavir/ritonavir: A multicentre retrospective matched cohort studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1024-2708&volume=9&issue=6&spage=399&epage=406&date=2003&atitle=Treatment+of+severe+acute+respiratory+syndrome+with+lopinavir/ritonavir:+a+multicentre+retrospective+matched+cohort+studyen_HK
dc.identifier.emailPeiris, JSM: malik@hkucc.hku.hken_HK
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_HK
dc.identifier.authorityPeiris, JSM=rp00410en_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid14660806-
dc.identifier.scopuseid_2-s2.0-10744223243en_HK
dc.identifier.hkuros87732-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-10744223243&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume9en_HK
dc.identifier.issue6en_HK
dc.identifier.spage399en_HK
dc.identifier.epage406en_HK
dc.publisher.placeHong Kongen_HK
dc.identifier.scopusauthoridChan, KS=7406031627en_HK
dc.identifier.scopusauthoridLai, ST=7402937038en_HK
dc.identifier.scopusauthoridChu, CM=7404345558en_HK
dc.identifier.scopusauthoridTsui, E=9240752200en_HK
dc.identifier.scopusauthoridTam, CY=55167657500en_HK
dc.identifier.scopusauthoridWong, MML=9278575000en_HK
dc.identifier.scopusauthoridTse, MW=36164618000en_HK
dc.identifier.scopusauthoridQue, TL=7003786628en_HK
dc.identifier.scopusauthoridPeiris, JSM=7005486823en_HK
dc.identifier.scopusauthoridSung, J=35405352400en_HK
dc.identifier.scopusauthoridWong, VCW=8503496500en_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.issnl1024-2708-

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