Lopinavir-ritonavir for SARS-CoV-2 infection: a systematic review

Abstract Background: SARS-CoV-2 is a new virus that first emerged in Wuhan, China in December 2019. The virus quickly spread throughout the countries, transforming the initial outbreak into a global pandemic. Lopinavir-ritonavir is an antiretroviral protease inhibitor combination drug that was proposed for the treatment of COVID-19 in the early phases of the pandemic. We conducted a systematic literature search on clinical trials assessing the efficacy and safety of lopinavir-ritonavir in patients hospitalized for COVID-19. 10 studies satisfying the inclusion criteria were analyzed and discussed in the current review. Four studies were randomized controlled trials, while the remaining had an observational design. The reported results are mixed, with some of the studies demonstrating the benefits of the combination drug, while others show little or no effect. These contradictory reports may be explained by the differences in study design, study population, the onset of treatment, and severity of disease, rendering this topic a subject for further debate.