Higher Rate of Hyperbilirubinemia and Arrythmia in COVID-19 Cases Receiving Combination Therapy Atazanavir /ritonavir vs. Lopinavir /ritonavir

Abstract

Background: Many treatments for COVID-19 are currently under studying,\nsuch as combination therapies with hydroxychloroquine plus antiviral\ndrugs. In this study, we compared the efficacy and side effects of two\ntypes of combination therapy including atazanavir /ritonavir (ATV/r) or\nlopinavir /ritonavir (LPV/r) plus hydroxychloroquine among COVID-19\npatients. Methods: In a non-randomized clinical trial, 108 eligible\npatients with moderate and severe form of COVID-19 were divided into two\ngroups. Each group consisted of 54 patients. One group received ATV/r\nplus hydroxychloroquine and the other group received hydroxychloroquine\nplus LPV/r. Then, the two groups were evaluated and compared for\nclinical symptoms, recovery rates and complications of treatment\nregimens. Results: The findings of this research showed a significant\nincrease in bilirubin in ATV/r receiving group compared to LPV/r\nreceivers (p<0.001). there was also a significant increase in\narrhythmias in the LPV/r group compared to ATV/r group during the\ntreatment period (p=0.019). Other findings including length of hospital\nstay, outcome, and treatment complications were not statistically\nsignificant. Conclusions: There is not statistically significant\ndifference between protease inhibitor drugs including ATV/r and LPV/r in\nthe treatment of COVID-19 regarding to progress and clinical outcomes.\nHowever, some side effects such as hyperbilirubinemia and arrhythmia was\nsignificantly different by application of atazanavir or lopinavir.