Lopinavir/ritonavir: Repurposing an old drug for HIV infection in COVID-19 treatment

• Main Authors: Paola Magro, Isabella Zanella, Marta Pescarolo, Francesco Castelli, Eugenia Quiros-Roldan
• Format: Article
• Language: English
• Published: Elsevier 2021-03-01
• Series: Biomedical Journal
• Subjects: Lopinavir; Ritonavir; Protease inhibitor; SARS-CoV-2; COVID-19 treatment
• Online Access: http://www.sciencedirect.com/science/article/pii/S2319417020302031

Currently, there is no specific antiviral treatment for COVID-19. However, drugs previously developed to treat other viral infections are being tested to verify if they might also be effective against SARS-CoV-2, the virus that causes COVID-19. Twenty years ago, the F.D.A. approved Lopinavir/ritonavir (LPV/r) to treat HIV infection. LPV and ritonavir were initially purposed to inhibit 3-chymotrypsin-like protease (3CLpro) of SARS-CoV and MERS-CoV and preliminary promising data on its efficacy for treating people infected with those viruses were available. Therefore, due to the high genetic similarities among those viruses and SARS-CoV-2, early during COVID-19 pandemic LPV/r was also proposed as one emergency treatment. We reviewed data from the literature about LPV/r treatment and SARS-CoV-2 infection, mainly focused on the efficacy and safety of this drugs for COVID-19 treatment. We can conclude that although up to date no clear benefit has been observed with the LPV/r treatment beyond standard care, its efficacy against SARS-COV-2 infection deserves further evaluations, particularly during the very early phase of the disease.