Safety and efficacy of artemisinin-piperaquine for treatment of COVID-19: an open-label, non-randomised and controlled trial

Int J Antimicrob Agents. 2021 Jan;57(1):106216. doi: 10.1016/j.ijantimicag.2020.106216. Epub 2020 Nov 2.

Abstract

Background: There are no effective therapies for patients with coronavirus disease-2019 (COVID-19).

Methods: Forty-one patients with confirmed COVID-19 were enrolled in the study and divided into two groups: artemisinin-piperaquine (AP) (n = 23) and control (n = 18). The primary outcome were the time taken to reach undetectable levels of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and the percentage of participants with undetectable SARS-CoV-2 on days 7, 10, 14, and 28. The computed tomography (CT) imaging changes within 10 days, corrected QT interval changes, adverse events, and abnormal laboratory parameters were the secondary outcomes.

Results: The mean time to reach undetectable viral RNA (mean ± standard deviation) was 10.6 ± 1.1 days (95% confidence interval [CI] 8.4-12.8) for the AP group and 19.3 ± 2.1 days (95% CI 15.1-23.5) for the control group. The percentages of patients with undetectable viral RNA on days 7, 10, 14, 21, and 28 were 26.1%, 43.5%, 78.3%, 100%, and 100%, respectively, in the AP group and 5.6%, 16.7%, 44.4%, 55.6%, and 72.2%, respectively, in the control group. The CT imaging within 10 days post-treatment showed no significant between-group differences (P > 0.05). Both groups had mild adverse events.

Conclusions: In patients with mild-to-moderate COVID-19, the time to reach undetectable SARS-CoV-2 was significantly shorter in the AP group than that in the control group. However, physicians should consider QT interval changes before using AP.

Keywords: Antimalarial; Artemisinin; COVID-19; Piperaquine; SARS-CoV-2.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Antiviral Agents / adverse effects*
  • Antiviral Agents / therapeutic use*
  • Artemisinins / adverse effects
  • Artemisinins / therapeutic use*
  • COVID-19 / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Long QT Syndrome / chemically induced
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / drug therapy
  • Lung Diseases / virology
  • Male
  • Middle Aged
  • Quinolines / adverse effects
  • Quinolines / therapeutic use*
  • RNA, Viral / blood
  • SARS-CoV-2 / genetics
  • Viral Load

Substances

  • Antiviral Agents
  • Artemisinins
  • Quinolines
  • RNA, Viral
  • artemisinin
  • piperaquine

Supplementary concepts

  • COVID-19 drug treatment