A systematic review of lopinavir therapy for SARS coronavirus and MERS coronavirus-A possible reference for coronavirus disease-19 treatment option

J Med Virol. 2020 Jun;92(6):556-563. doi: 10.1002/jmv.25729. Epub 2020 Mar 12.


In the past few decades, coronaviruses have risen as a global threat to public health. Currently, the outbreak of coronavirus disease-19 (COVID-19) from Wuhan caused a worldwide panic. There are no specific antiviral therapies for COVID-19. However, there are agents that were used during the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) epidemics. We could learn from SARS and MERS. Lopinavir (LPV) is an effective agent that inhibits the protease activity of coronavirus. In this review, we discuss the literature on the efficacy of LPV in vitro and in vivo, especially in patients with SARS and MERS, so that we might clarify the potential for the use of LPV in patients with COVID-19.

Keywords: COVID-19; MERS; SARS; coronavirus; lopinavir.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Animals
  • Antiviral Agents / therapeutic use*
  • Betacoronavirus / drug effects
  • Betacoronavirus / enzymology
  • Betacoronavirus / pathogenicity
  • COVID-19
  • Cell Line
  • Clinical Trials as Topic
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / virology
  • Disease Models, Animal
  • Humans
  • Lopinavir / therapeutic use*
  • Mice
  • Middle East Respiratory Syndrome Coronavirus / drug effects
  • Middle East Respiratory Syndrome Coronavirus / enzymology
  • Middle East Respiratory Syndrome Coronavirus / pathogenicity
  • Pandemics*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / virology
  • Ritonavir / therapeutic use*
  • SARS-CoV-2
  • Severe Acute Respiratory Syndrome / diagnosis
  • Severe Acute Respiratory Syndrome / drug therapy*
  • Severe Acute Respiratory Syndrome / epidemiology
  • Severe Acute Respiratory Syndrome / virology
  • Severe acute respiratory syndrome-related coronavirus / drug effects
  • Severe acute respiratory syndrome-related coronavirus / enzymology
  • Severe acute respiratory syndrome-related coronavirus / pathogenicity
  • Treatment Outcome


  • Antiviral Agents
  • Lopinavir
  • Ritonavir