Indian Journal of Medical Research

PROTOCOL
Year
: 2020  |  Volume : 151  |  Issue : 2  |  Page : 184--189

Lopinavir/ritonavir combination therapy amongst symptomatic coronavirus disease 2019 patients in India: Protocol for restricted public health emergency use


Tarun Bhatnagar1, Manoj V Murhekar3, Manish Soneja2, Nivedita Gupta3, Sidhartha Giri3, Naveet Wig2, Raman Gangakhedkar3 
1 School of Public Health, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
2 Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
3 Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India

Correspondence Address:
Dr Manoj V Murhekar
National Institute of Epidemiology, R127, TNHB, Ayapakkam, Chennai 600 077, Tamil Nadu
India

As of February 29, 2020, more than 85,000 cases of coronavirus disease 2019 (COVID-19) have been reported from China and 53 other countries with 2,924 deaths. On January 30, 2020, the first laboratory-confirmed case of COVID was reported from Kerala, India. In view of the earlier evidence about effectiveness of repurposed lopinavir/ritonavir against severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus (CoV), as well as preliminary docking studies conducted by the ICMR-National Institute of Virology, Pune, the Central Drugs Standard Control Organization approved the restricted public health use of lopinavir/ritonavir combination amongst symptomatic COVID-19 patients detected in the country. Hospitalized adult patients with laboratory-confirmed SARS-CoV-2 infection with any one of the following criteria will be eligible to receive lopinavir/ritonavir for 14 days after obtaining written informed consent: (i) respiratory distress with respiratory rate ≥22/min or SpO2of <94 per cent; (ii) lung parenchymal infiltrates on chest X-ray; (iii) hypotension defined as systolic blood pressure <90 mmHg or need for vasopressor/inotropic medication; (iv) new-onset organ dysfunction; and (v) high-risk groups - age >60 yr, diabetes mellitus, renal failure, chronic lung disease and immunocompromised persons. Patients will be monitored to document clinical (hospital length of stay and mortality at 14, 28 and 90 days), laboratory (presence of viral RNA in serial throat swab samples) and safety (adverse events and serious adverse events) outcomes. Treatment outcomes amongst initial cases would be useful in providing guidance about the clinical management of patients with COVID-19. If found useful in managing initial SARS-CoV-2-infected patients, further evaluation using a randomized control trial design is warranted to guide future therapeutic use of this combination.


How to cite this article:
Bhatnagar T, Murhekar MV, Soneja M, Gupta N, Giri S, Wig N, Gangakhedkar R. Lopinavir/ritonavir combination therapy amongst symptomatic coronavirus disease 2019 patients in India: Protocol for restricted public health emergency use.Indian J Med Res 2020;151:184-189


How to cite this URL:
Bhatnagar T, Murhekar MV, Soneja M, Gupta N, Giri S, Wig N, Gangakhedkar R. Lopinavir/ritonavir combination therapy amongst symptomatic coronavirus disease 2019 patients in India: Protocol for restricted public health emergency use. Indian J Med Res [serial online] 2020 [cited 2021 Sep 23 ];151:184-189
Available from: https://www.ijmr.org.in/article.asp?issn=0971-5916;year=2020;volume=151;issue=2;spage=184;epage=189;aulast=Bhatnagar;type=0