Use of Darunavir-Cobicistat as a Treatment Option for Critically Ill Patients with SARS-CoV-2 Infection

Yonsei Med J. 2020 Sep;61(9):826-830. doi: 10.3349/ymj.2020.61.9.826.

Abstract

We retrospectively reviewed patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who were admitted to an intensive care unit in Daegu, South Korea. The outcomes of patients who did (cases) or did not (controls) receive darunavir-cobicistat (800-150 mg) therapy were compared. Fourteen patients received darunavir-cobicistat treatment, and 96 received other antiviral therapy (controls). Overall, the darunavir-cobicistat group comprised patients with milder illness, and the crude mortality rate of all patients in the darunavir-cobicistat group was lower than that in the controls [odds ratio (OR) 0.20, 95% confidence interval (CI) 0.04-0.89, p=0.035]. After 1:2 propensity-score matching, there were 14 patients in the darunavir-cobicistat group, and 28 patients in the controls. In propensity score-matched analysis, the darunavir-cobicistat group had lower mortality than the controls (OR 0.07, 95% CI 0.01-0.52, p=0.009). In conclusion, darunavir-cobicistat therapy was found to be associated with a significant survival benefit in critically ill patients with SARS-CoV-2 infection.

Keywords: Coronavirus disease 2019; darunavir-cobicistat; severe acute respiratory syndrome coronavirus 2.

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use*
  • Betacoronavirus
  • COVID-19
  • Case-Control Studies
  • Cobicistat / administration & dosage
  • Cobicistat / adverse effects
  • Cobicistat / therapeutic use*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / mortality
  • Critical Illness
  • Darunavir / administration & dosage
  • Darunavir / adverse effects
  • Darunavir / therapeutic use*
  • Female
  • HIV Protease Inhibitors / administration & dosage
  • HIV Protease Inhibitors / adverse effects
  • HIV Protease Inhibitors / therapeutic use*
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / mortality
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Anti-HIV Agents
  • HIV Protease Inhibitors
  • Cobicistat
  • Darunavir