Quadruple therapy for asymptomatic COVID-19 infection patients

Expert Rev Anti Infect Ther. 2020 Jul;18(7):617-624. doi: 10.1080/14787210.2020.1758066. Epub 2020 May 3.

Abstract

Introduction: The novel coronavirus (COVID-19) is currently in epidemic stage. After large-scale interpersonal infection, asymptomatic patients appear. Whether asymptomatic patients are contagious or not and whether they need medication are the arguments among clinical experts.

Areas covered: This paper reports a special asymptomatic couple with COVID-19, of which the male patient is an intercity bus driver but has not induced confirmed infection of his 188 passengers. The patients were treated with four combinations of lopinavir/ritonavir tablets, arbidol tablets, Lianhuaqingwen granules, and recombinant human interferon-α2b (IFN-α2b) injection via aerosol. Their clinical characteristics and medication were summarized and analyzed.

Expert opinion: The two asymptomatic patients far away from Wuhan did not seem to be highly contagious. They improved obviously, after treatment with the quadruple therapy, but the effective drug is still unknown. It should be noted that lopinavir/ritonavir tablets have many drug interactions and are the most likely drugs to cause hyperlipidemia and hyperglycemia in these two patients. IFN-α2b is more effective in the early stage of virus infection. Arbidol instruction dose may not be sufficient to inhibit the novel coronavirus in vivo. The evidence-based medicine of Lianhuaqingwen granules for treating various viral infections is just based on Chinese patients.

Keywords: COVID-19; IFN-α; adverse drug reaction; arbidol; asymptomatic; lopinavir; ritonavir.

Publication types

  • Case Reports

MeSH terms

  • Asymptomatic Infections*
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Indoles / administration & dosage
  • Interferon-alpha / administration & dosage
  • Lopinavir / administration & dosage
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Ritonavir / administration & dosage
  • SARS-CoV-2

Substances

  • Indoles
  • Interferon-alpha
  • Interferon-alpha2b
  • Lopinavir
  • umifenovir
  • Ritonavir

Supplementary concepts

  • COVID-19 drug treatment

Grant support

This paper was not funded.