Efficacy and safety of lopinavir/ritonavir in the treatment of COVID-19: A systematic review

Betsy Ann Joseph, Mahmoud Dibas, Kirk W. Evanson, Geeta Paranjape, Charan Thej Reddy Vegivinti, Pragadeesh Thamarai Selvan, Kavitha Saravu, Nitin Gupta, Yashwitha Sai Pulakurthi, Praneeth Reddy Keesari, Sriram Varsha, Spandana Chittajallu, Adam A. Dmytriw, Natalie L. Reierson, Nick Mikoff, Shelby Kamrowski, Megan Schmidt, Amber R. Davis, John M. Pederson, Hemant K. MishraJillienne C. Touchette, Kevin Kallmes

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


Objectives: To systematically review the clinical literature reporting the use of Lopinavir/ritonavir (LPV/r) for the treatment of patients with Cornonavirus disease 19 (COVID-19) to assess the efficacy of LPV/r for the treatment of COVID-19. Methods: The authors systematically searched PubMed and MedRxiv databases for studies describing treatment of COVID-19 patients using LPV/r compared to other therapies. Articles were excluded if they were case reports, opinion editorials, preclinical studies, single-armed studies, not written in English, not relevant to the topic, or published before May 2020. The included outcomes were viral clearance as measured by reverse-transcription polymerase chain reaction (RT-PCR) negativity and/or improvement on chest computed tomography (CT), mortality, and adverse events. Results: Among 858 total studies, 16 studies met the inclusion criteria and were included in the qualitative review. These studies consisted of 3 randomized control trials, 3 open-label trials, and 10 observational studies. Most of these studies did not report positive clinical outcomes with LPV/r treatment. Conclusion: The systematic review revealed insufficient evidence of effectiveness and clinical benefit of LPV/r in the treatment of COVID-19 patients. Specifically, LPV/r does not appear to improve clinical outcome, mortality, time to RT-PCR negativity, or chest CT clearance in patients with COVID-19.

Original languageEnglish (US)
Pages (from-to)679-687
Number of pages9
JournalExpert review of anti-infective therapy
Issue number6
Early online dateDec 21 2020
StatePublished - Dec 21 2020

Bibliographical note

Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.


  • Coronavirus
  • antiviral agents
  • lopinavir/ritonavir
  • pneumonia
  • sars virus
  • severe acute respiratory syndrome


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