Original Research

Retrospective analysis of severe COVID-19 pneumonia patients treated with lopinavir/ritonavir: A comparison with survivor and non-survivor patients

Omer Ayten, Bengu Saylan
Southern African Journal of Infectious Diseases | Vol 35, No 1 | a233 | DOI: https://doi.org/10.4102/sajid.v35i1.233 | © 2020 Omer Ayten, Bengu Saylan | This work is licensed under CC Attribution 4.0
Submitted: 14 July 2020 | Published: 21 December 2020

About the author(s)

Omer Ayten, Department of Pulmonology Medicine, Faculty of Health Sciences, Sultan Abdulhamit Han Education and Training Hospital, Uskudar/Istanbul, Turkey
Bengu Saylan, Department of Pulmonology Medicine, Faculty of Health Sciences, Sultan Abdulhamit Han Education and Training Hospital, Uskudar/Istanbul, Turkey


Background: Currently there is no proven medical treatment for COVID-19. We aimed to determine the factors affecting mortality and changes in clinical and laboratory findings in patients with severe COVID-19 pneumonia treated with lopinavir/ritonavir (Lpv/r).

Methods: Data of survivor and non-survivor severe COVID-19 pneumonia patients treated with Lpv/r were analysed retrospectively.

Results: A total of 73 patients, 26 (35.6%) females and 47 (64.4%) males were included in the study. The mean age of non-survivor and survivor patients was 64.3 ± 12 and 52.6 ± 12.2, respectively (p < 0.0001). Frequency of smoking and comorbid diseases was higher in non-survivor patients than in survivor patients (37% vs. 8.7% p = 0.003 and 92.6% vs. 28.3%, p < 0.0001, respectively). Age (Odds ratio [OR] 1.09, 95% confidence interval [95% CI] 1.03–1.14), smoking (OR 6.18, 1.7–22.42), presence of comorbid disease (OR 31.73, 6.26–153.56), coronary artery disease (OR 9.26, 1.79–47.77), arrhythmia (OR 13.8, 1.56–122.22), hypertension (OR 14, 4.28–45.74), diabetes (OR 7.22, 2–25.99) and congestive heart failure (OR 10.22, 1.13–92.93) were statistically associated with increased mortality (p < 0.05). Also increased neutrophil (OR 1.26, 1.08–1.46), C-reactive protein (CRP) (OR 1.01, 1.003–0.02), lactate dehydrogenase (LDH), (OR 1.002, 1.001–1.004), D-dimer (OR 1.001, 1.002–1.003), and aspartate transaminase (AST) levels (OR 1.05, 1.02–1.08 were associated with increased mortality.

Conclusion: The presence of advanced age, active smoking, comorbidity, especially hypertension, diabetes, arrhythmia, coronary artery disease, congestive heart failure and neutrophil, C-reactive protein, lactate dehydrogenase, D-dimer and aspartate transaminase were associated with mortality. The efficacy of Lpv/r, warrants further verification in future studies.


COVID-19; lopinavir; ritonavir; mortality; severe pneumonia.


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