Three out of the nine patients who have tested positive for COVID-19 at the Mumbai’s Kasturba Hospital have been started on combination of anti-HIV drugs lopinavir and ritonavir. Since the outbreak, the two antiretroviral drugs have been only used in Jaipur for an Italian couple infected with the virus. Based on the positive outcome, the Indian Council of Medical Research has published the use of this combination drugs as a treatment protocol for “restricted public health emergency use”.

Dr. Rajni Kant, director, ICMR’s Regional Medical Research Centre, told The Hindu that the initial findings of using the combination had shown a good result. “We have published the treatment protocol in the Indian Journal of Medical Research and sent it for approval from the Drug Controller General of India,” Dr. Kant said.

The two-drug combination has earlier shown effectiveness against severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus (CoV). “The combination treatment is approved for emergency public health use, only amongst laboratory-confirmed patients with moderate degree of severity and not designed as a controlled clinical trial. However, the treatment outcomes amongst the first few cases would be useful in providing guidance about clinical management of COVID-19 cases in future,” the IJMR paper states.

Of the nine patients admitted in Mumbai, six are senior citizens while remaining three are in the age group of 30-40. While all the senior citizens have co-morbid conditions like diabetes and hypertension, one of them is currently on oxygen support. A doctor from the hospital said that besides the anti-HIV drugs, they have also used anti-malarial drug chloroquine and anti-H1N1 drug oseltamivir for patients who were suspected with dual infection. “One of the patients has tested positive for H1N1 along with COVID-19”, the doctor said adding that all the nine patients are stable and some of them are asymptomatic.