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Abstract：
A life-threatening respiratory illness (COVID-19) due to severe acute respiratory syndrome (SARS)-CoV-2 coronavirus was first described in December 2019 in Wuhan (China), rapidly evolving into a pandemic. In the first phase, when the viral replication plays a pivotal pathogenetic role, antiviral drugs could be crucial in limiting viral-induced organ damage. Unfortunately, there are no specific antivirals of proven efficacy for COVID-19, and several drugs have been repurposed to face this dramatic pandemic. In this paper we review the studies evaluating lopinavir/ritonavir association (LPV/r) use in COVID-19, and previously in SARS and Middle East respiratory syndrome (MERS). We searched PubMed to identify all relevant clinical and laboratory studies published up to 15 May 2020; the guidelines on the use of LPV/r in COVID-19 were further directly searched on the website of the main international scientific societies and agencies. Available evidence is currently scarce and of low quality. The recommendations issued for COVID-19 vary from positions clearly against the use of LPV/r to other positions that are more favorable. In our opinion, despite the controversial results of an important randomized clinical trial, and some recommendations, clinicians should not abandon the use of LPV/r for the treatment of COVID-19, possibly using this drug inside a prospective randomized trial, waiting for the results of the numerous ongoing trials evaluating its efficacy.
摘要：
2019年12月，武汉（中国）首次描述了一种由严重急性呼吸道综合症（SARS）-CoV-2冠状病毒引起的危及生命的呼吸系统疾病（COVID-19）。迅速演变成大流行。在第一阶段,当病毒复制起着关键的致病作用时，抗病毒药物在限制病毒诱导的器官损伤方面可能是至关重要的。不幸的是,目前尚无对COVID-19有效的特异性抗病毒药物，并且已经将几种药物重新用于应对这种严重的大流行。在本文中，我们回顾了评估洛匹那韦/利托那韦协会（LPV/r）在COVID-19中以及先前在SARS和中东呼吸综合征（MERS）中使用的研究。我们搜索了PubMed，以确定截至2020年5月15日发表的所有相关临床和实验室研究；在主要国际科学学会和机构的网站上进一步直接搜索了关于在COVID-19中使用LPV/r的指南。现有的证据目前很少，质量也很低。针对COVID-19发布的建议从明显反对使用LPV/r的立场到更有利的其他立场有所不同。在我们看来,尽管一项重要的随机临床试验有争议的结果，和一些建议，临床医生不应该放弃使用LPV/r治疗COVID-19，可能在前瞻性随机试验中使用这种药物，等待众多正在进行的评价其疗效的试验结果.
