Chloroquine, arbidol (umifenovir) or lopinavir/ritonavir as the antiviral monotherapy for COVID-19 patients: a retrospective cohort study

Abstract Background: The severe acute respiratory syndrome coronavirus-2 outbreak was identified in China in December 2019 and spread worldwide, reaching the pandemic levels. However, a specific, effective and proven therapy for the patients with coronavirus disease 2019 (COVID-19) remains elusive. We aim to compare the efficacy and the safety of three antiviral monotherapies (chloroquine phosphate, arbidol (Umifenovir) or lopinavir/ritonavir) in non-severe, hospitalised COVID-19 patients.Methods: We retrospectively analysed the hospitalised, laboratory-confirmed COVID-19 patients, treated with antiviral monotherapies at Huizhou Municipal Central Hospital between Jan 19 and Mar 16, 2020. Demographic and clinical data were extracted from electronic medical records. The primary outcome of the study was the viral shedding interval.Results: Twenty-seven patients with COVID-19 were included in the study with 10 receiving chloroquine phosphate, 11 receiving arbidol and 6 receiving lopinavir/ritonavir. Baseline demographics and clinical data were similar between groups. The median viral shedding interval in the lopinavir/ritonavir group was 13.0 days (95% CI: 12.2-23.8), while significantly shorter in the chloroquine group at 5.0 days (95% CI: 0.4-9.6) (p=0.003). A reduced median interval was also observed in the arbidol group, with 8.0 days (95%CI: 4.9-11.1) (p=0.008). Moreover, the hospitalisation duration was shorter in the chloroquine (9.3 ± 1.8 days, p<0.001) and arbidol groups (11.7 ± 3.7 days, p<0.001), and the hospitalisation costs were significantly reduced in the chloroquine (USD 1327 ± 566, p=0.001) and arbidol groups (USD 1167 ± 434, p<0.001), when compared with the lopinavir/ritonavir group (hospitalisation length and costs: 19.7 ± 4.4 days and USD 3806 ± 2262, respectively). Conclusions: Chloroquine and arbidol could not only shorten the viral shedding interval but also decreased the hospitalisation duration and hospitalisation expenses.Trial registration: The ethics committee of the Huizhou Municipal Central Hospital approved this study, and the trial was registered with www.chictr.org.cn (ChiCTR2000030931).