Prospective Analysis of a Combination Therapy Protocol of Lopinavir/Ritonavir, Chloroquine Phosphate, and Ribavirin on COVID-19 Patients

Abstract

Background: Timely diagnosis and treatment of coronavirus disease 2019 (COVID-19) present significant global medical challenges. Objectives: This study aimed to evaluate the laboratory markers and clinical outcomes in COVID-19 patients treated with a combination therapy protocol comprising lopinavir/ritonavir, chloroquine (CQ) phosphate, and ribavirin. Methods: In this single-arm prospective study, out of 127 COVID-19 patients recruited, 122 were comprehensively assessed for clinical and laboratory changes from the day of admission (prior to medication initiation) to the ninth day of treatment. Results: Overall, the levels of lymphocytes, lactate dehydrogenase (LDH), interleukin (IL)-6, IL-10, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly modulated after treatment compared to baseline levels (P < 0.05). Disease severity was not significantly correlated with sex (P = 0.85) or age (P = 0.47), but it was strongly associated with underlying health conditions [P = 0.005, OR (95% CI): 2.96 (1.39 - 6.31)]. Among all biomarkers, only CRP showed a significant correlation with age (P = 0.03), with greater modulation observed in patients over 50 years. The survival rate was 94.3%, with 7 patient fatalities (5.7%). Conclusions: The combination therapy protocol of lopinavir/ritonavir, chloroquine phosphate, and ribavirin may modulate cytokine levels and hematological markers in COVID-19 patients. However, further investigation is required to draw conclusions about its impact on clinical outcomes.