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Efficacy of Lopinavir Combined with Doxycycline for Treatment of COVID-19: A Retrospective Comparison of Two Cohorts
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  • FERHAT ARSLAN,
  • Ali Mert,
  • Mehmet Bayram,
  • Sacit Icten,
  • Pınar Ergen,
  • Ozlem Aydin,
  • Ayse Ucişik,
  • Fatma Yilmaz Karadag,
  • Hülya Caskurlu,
  • Bahadir Ceylan,
  • Selda Aydin,
  • Muhammed Akkoyunlu,
  • Mustafa Duger,
  • Okan Derin,
  • Abdullah Kansu,
  • Sedef Basgonul,
  • Tulin Akarsu,
  • Hasan Kocoglu,
  • Yasemin Cag,
  • Haluk Vahaboglu
FERHAT ARSLAN
Medeniyet Universitesi Goztepe Egitim ve Arastirma Hastanesi
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Ali Mert
Istanbul Medipol University
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Mehmet Bayram
Istanbul Medipol University
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Sacit Icten
Goztepe Training and Research Hospital
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Pınar Ergen
Goztepe Training and Research Hospital
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Ozlem Aydin
Goztepe Training and Research Hospital
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Ayse Ucişik
Goztepe Training and Research Hospital
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Fatma Yilmaz Karadag
Goztepe Training and Research Hospital
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Hülya Caskurlu
Medeniyet Universitesi Goztepe Egitim ve Arastirma Hastanesi
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Bahadir Ceylan
Istanbul Medipol University
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Selda Aydin
Istanbul Medipol University
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Muhammed Akkoyunlu
Istanbul Medipol University
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Mustafa Duger
Istanbul Medipol University
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Okan Derin
Istanbul Medipol University
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Abdullah Kansu
Istanbul Medipol University
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Sedef Basgonul
Istanbul Medipol University
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Tulin Akarsu
Goztepe Training and Research Hospital
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Hasan Kocoglu
Medeniyet Universitesi Goztepe Egitim ve Arastirma Hastanesi
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Yasemin Cag
Medeniyet Universitesi Goztepe Egitim ve Arastirma Hastanesi
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Haluk Vahaboglu
Medeniyet Universitesi Goztepe Egitim ve Arastirma Hastanesi
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Abstract

Introduction: Though there is currently no approved treatment for COVID-19, potential medications include lopinavir and doxycycline. Lopinavir is a broad-spectrum protease inhibitor successfully used during the SARS outbreak. Doxycycline is an antibiotic with immunomodulatory effects, which successfully treats dengue hemorrhagic fever. Comparing lopinavir combined with doxycycline with other commonly implemented COVID-19 treatment regimens is of medical significance. Methods: We conducted a retrospective study comparing two cohorts. One cohort strictly adhered to a treatment protocol of lopinavir combined with doxycycline (Lop/Dox), while the other cohort (Others) applied protocols based on combinations of favipiravir, hydroxychloroquine, and azithromycin. The outcomes evaluated were death from coronavirus and intubation. Results: During the study period, 161 and 114 patients were followed in the Lop/Dox cohort and the Others cohort, respectively. The Lop/Dox cohort was older and had lower O2 saturation at admission. The proportion of patients needing intubation did not differ between the cohorts (Lop/Dox, 15∙5%; Others, 16∙7%). The overall fatality rate likewise did not differ (12∙4%) in Lop/Dox and 8∙7% in the Others cohort). Older age and elapsed time between the onset of symptoms and hospitalization, O2 saturation at admission, and the lymphocyte to white blood cell ratio were independent risk factors for poor outcomes of the illness. Conclusion: This study showed that lopinavir plus doxycycline therapy is an effective treatment amongst moderate to severe COVID-19 patients.