@article{Tangara:2026:10.1016/j.eclinm.2025.103735,
author = {Tangara, B and Barsosio, HC and Marlais, T and Kabore, JMT and Tiono, AB and Otieno, K and Wanjiku, M and Achieng, M and Onyango, ED and Ondieki, ED and Aura, H and Odawo, T and Allen, DJ and Hannan, L and Tetteh, KK and Soulama, I and Ouedraogo, A and Serme, SS and Soulama, BI and Barry, A and Badoum, ES and Matthewman, J and Brazal-Monzó, H and Canizales, J and Drabko, A and Wu, W and Kariuki, S and Lesosky, M and Sirima, SB and Drakeley, C and Ter, Kuile FO},
doi = {10.1016/j.eclinm.2025.103735},
journal = {EClinicalMedicine},
title = {Artemether-lumefantrine versus pyronaridine-artesunate for the treatment of malaria in patients with mild to moderate COVID-19 in Kenya and Burkina Faso: a randomised open-label trial (MALCOV).},
url = {http://dx.doi.org/10.1016/j.eclinm.2025.103735},
volume = {91},
year = {2026}
}

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TY  - JOUR
AB  - BACKGROUND: It is unknown whether the choice of malaria treatment for uncomplicated malaria affects coronavirus disease 2019 (COVID-19) severity, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load, or duration of viral shedding. Several antimalarials exhibit antiviral activity against SARS-CoV-2 in vitro and have been suggested as potential therapeutic candidates for COVID-19, particularly pyronaridine-artesunate (PA), despite disappointing clinical results with chloroquine and hydroxychloroquine. METHODS: We conducted an open-label randomised trial comparing standard 3-day treatment with PA and artemether-lumefantrine (AL) in newly diagnosed SARS-CoV-2 infected patients aged ≥6 months with rapid diagnostic test or microscopy-confirmed non-severe malaria in Kenya and Burkina Faso. SARS-CoV-2 was assessed by RT-PCR on days 3, 7, 14, and 28, and symptom resolution was assessed daily for 14 days using FLU-PRO Plus. The primary endpoint was the proportion of participants with SARS-CoV-2 clearance by day 7. Secondary endpoints included SARS-CoV-2 clearance by days 14, 21, and 28, time to SARS-CoV-2 clearance over 28 days, median viral load on day 7, and time to symptom resolution. Complete case analysis was conducted using log-binomial regression for binary outcomes, Cox-regression for time-to-event outcomes, and negative binomial regression for count outcomes, all adjusted for disease severity and viral load at enrolment. The trial is registered with ClinicalTrials.gov NCT04695197. FINDINGS: From January 2021 to January 2022, 143 participants were randomised (PA = 69, AL = 74, intention-to-treat [ITT] population), including 117 with reverse transcription polymerase chain reaction (RT-PCR) confirmed (PA = 58, AL = 59, modified intention-to-treat [mITT] population) and 26 with rapid-antigen test confirmed SARS-CoV-2 infection. The median age was 19 years (interquartile range [IQR] 13-38), 66% were aged ≥15 years. Baseline characteristics were co
AU  - Tangara,B
AU  - Barsosio,HC
AU  - Marlais,T
AU  - Kabore,JMT
AU  - Tiono,AB
AU  - Otieno,K
AU  - Wanjiku,M
AU  - Achieng,M
AU  - Onyango,ED
AU  - Ondieki,ED
AU  - Aura,H
AU  - Odawo,T
AU  - Allen,DJ
AU  - Hannan,L
AU  - Tetteh,KK
AU  - Soulama,I
AU  - Ouedraogo,A
AU  - Serme,SS
AU  - Soulama,BI
AU  - Barry,A
AU  - Badoum,ES
AU  - Matthewman,J
AU  - Brazal-Monzó,H
AU  - Canizales,J
AU  - Drabko,A
AU  - Wu,W
AU  - Kariuki,S
AU  - Lesosky,M
AU  - Sirima,SB
AU  - Drakeley,C
AU  - Ter,Kuile FO
DO  - 10.1016/j.eclinm.2025.103735
PY  - 2026///
TI  - Artemether-lumefantrine versus pyronaridine-artesunate for the treatment of malaria in patients with mild to moderate COVID-19 in Kenya and Burkina Faso: a randomised open-label trial (MALCOV).
T2  - EClinicalMedicine
UR  - http://dx.doi.org/10.1016/j.eclinm.2025.103735
UR  - https://www.ncbi.nlm.nih.gov/pubmed/41552003
VL  - 91
ER  - 

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