The impact of sofosbuvir/daclatasvir or ribavirin in patients with severe COVID-19.

Autor:	Eslami G; Abadan Faculty of Medical Sciences, Abadan, Iran., Mousaviasl S; Abadan Faculty of Medical Sciences, Abadan, Iran., Radmanesh E; Abadan Faculty of Medical Sciences, Abadan, Iran., Jelvay S; Abadan Faculty of Medical Sciences, Abadan, Iran., Bitaraf S; Department of Epidemiology, Tehran University of Medical Sciences, Tehran, Iran., Simmons B; Faculty of Medicine, Imperial College London, London, UK., Wentzel H; Faculty of Medicine, Imperial College London, London, UK., Hill A; Department of Translational Medicine, University of Liverpool, UK., Sadeghi A; Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute Tehran University of Medical Sciences, Tehran, Iran., Freeman J; Global Health New Zealand, New Zealand., Salmanzadeh S; Infectious and Tropical Diseases Research Centre, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran., Esmaeilian H; Abadan Faculty of Medical Sciences, Abadan, Iran., Mobarak M; Abadan Faculty of Medical Sciences, Abadan, Iran., Tabibi R; Abadan Faculty of Medical Sciences, Abadan, Iran., Jafari Kashi AH; Abadan Faculty of Medical Sciences, Abadan, Iran., Lotfi Z; Abadan Faculty of Medical Sciences, Abadan, Iran., Talebzadeh SM; Abadan Faculty of Medical Sciences, Abadan, Iran., Wickramatillake A; University of Moratuwa, Moratuwa, Sri Lanka., Momtazan M; Abadan Faculty of Medical Sciences, Abadan, Iran., Hajizadeh Farsani M; Abadan Faculty of Medical Sciences, Abadan, Iran., Marjani S; Abadan Faculty of Medical Sciences, Abadan, Iran., Mobarak S; Abadan Faculty of Medical Sciences, Abadan, Iran.
Jazyk:	angličtina
Zdroj:	The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2020 Nov 01; Vol. 75 (11), pp. 3366-3372.
DOI:	10.1093/jac/dkaa331
Abstrakt:	Objectives: Sofosbuvir and daclatasvir are direct-acting antivirals highly effective against hepatitis C virus. There is some in silico and in vitro evidence that suggests these agents may also be effective against SARS-CoV-2. This trial evaluated the effectiveness of sofosbuvir in combination with daclatasvir in treating patients with COVID-19. Methods: Patients with a positive nasopharyngeal swab for SARS-CoV-2 on RT-PCR or bilateral multi-lobar ground-glass opacity on their chest CT and signs of severe COVID-19 were included. Subjects were divided into two arms with one arm receiving ribavirin and the other receiving sofosbuvir/daclatasvir. All participants also received the recommended national standard treatment which, at that time, was lopinavir/ritonavir and single-dose hydroxychloroquine. The primary endpoint was time from starting the medication until discharge from hospital with secondary endpoints of duration of ICU stay and mortality. Results: Sixty-two subjects met the inclusion criteria, with 35 enrolled in the sofosbuvir/daclatasvir arm and 27 in the ribavirin arm. The median duration of stay was 5 days for the sofosbuvir/daclatasvir group and 9 days for the ribavirin group. The mortality in the sofosbuvir/daclatasvir group was 2/35 (6%) and 9/27 (33%) for the ribavirin group. The relative risk of death for patients treated with sofosbuvir/daclatasvir was 0.17 (95% CI 0.04-0.73, P = 0.02) and the number needed to treat for benefit was 3.6 (95% CI 2.1-12.1, P < 0.01). Conclusions: Given these encouraging initial results, and the current lack of treatments proven to decrease mortality in COVID-19, further investigation in larger-scale trials seems warranted. (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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