tetano
Editor, Senior Moderator
Ann Med
. 2024 Dec;56(1):2313062.
doi: 10.1080/07853890.2024.2313062. Epub 2024 Feb 14. Associations of nirmatrelvir-ritonavir treatment with death and clinical improvement in hospitalized patients with COVID-19 during the Omicron wave in Beijing, China: a multicentre, retrospective cohort study
Xiaobo Han[SUP] 1 2 [/SUP], Chenglong Li[SUP] 3 4 [/SUP], Xin Yuan[SUP] 5 [/SUP], Junchang Cui[SUP] 1 2 [/SUP], Zhihai Han[SUP] 6 [/SUP], Jiguang Meng[SUP] 7 8 [/SUP], Weiguo Zhao[SUP] 1 [/SUP], Fei Xie[SUP] 9 [/SUP], Kaifei Wang[SUP] 9 [/SUP], Yuhong Liu[SUP] 1 [/SUP], Guoxin Muo[SUP] 1 [/SUP], Na Xi[SUP] 10 [/SUP], Mengli Zheng[SUP] 1 2 [/SUP], Rentao Wang[SUP] 1 2 [/SUP], Kun Xiao[SUP] 1 2 [/SUP], Wei Chen[SUP] 6 [/SUP], Junchen Xiong[SUP] 6 7 [/SUP], Dahui Zhao[SUP] 9 [/SUP], Xinxin Zhang[SUP] 1 [/SUP], Xinjie Han[SUP] 1 [/SUP], Haibo Cheng[SUP] 11 [/SUP], Zhongkuo Yu[SUP] 1 2 [/SUP], Yinghan Shi[SUP] 1 2 [/SUP], Wuxiang Xie[SUP] 12 13 [/SUP], Lixin Xie[SUP] 1 2 [/SUP]
Affiliations
Background: The effectiveness of nirmatrelvir-ritonavir has mainly been shown in non-hospitalized patients with mild-to-moderate coronavirus disease 2019 (COVID-19). The real-world effectiveness of nirmatrelvir-ritonavir urgently needs to be determined using representative in-hospital patients with COVID-19 during the Omicron wave of the pandemic.
Methods: We performed a multicentre, retrospective study in five Chinese PLA General Hospital medical centers in Beijing, China. Patients hospitalized with COVID-19 from 10 December 2022 to 20 February 2023 were eligible for inclusion. A 1:1 propensity score matching was performed between the nirmatrelvir-ritonavir group and the control group.
Results: 1010 recipients of nirmatrelvir-ritonavir and 1010 matched controls were finally analyzed after matching. Compared with matched controls, the nirmatrelvir-ritonavir group had a lower incidence rate of all-cause death (4.6/1000 vs. 6.3/1000 person-days, p = 0.013) and a higher incidence rate of clinical improvement (47.6/1000 vs. 45.8/1000 person-days, p = 0.012). Nirmatrelvir-ritonavir was associated with a 22% lower all-cause mortality and a 14% higher incidence of clinical improvement. Initiation of nirmatrelvir-ritonavir within 5 days after symptom onset was associated with a 50% lower mortality and a 26% higher clinical improvement rate. By contrast, no significant associations were identified among patients receiving nirmatrelvir-ritonavir treatment more than 5 days after symptom onset. Nirmatrelvir-ritonavir was also associated with a 50% increase in survival days and a 12% decrease in days to clinical improvement.
Conclusion: Among hospitalized patients with COVID-19 during the Omicron wave in Beijing, China, the early initiation of nirmatrelvir-ritonavir was associated with clinical benefits of lowering mortality and improving clinical recovery.
Keywords: Covid-19; all-cause death; clinical improvement; nirmatrelvir-ritonavir; off-label treatment; real-world.
. 2024 Dec;56(1):2313062.
doi: 10.1080/07853890.2024.2313062. Epub 2024 Feb 14. Associations of nirmatrelvir-ritonavir treatment with death and clinical improvement in hospitalized patients with COVID-19 during the Omicron wave in Beijing, China: a multicentre, retrospective cohort study
Xiaobo Han[SUP] 1 2 [/SUP], Chenglong Li[SUP] 3 4 [/SUP], Xin Yuan[SUP] 5 [/SUP], Junchang Cui[SUP] 1 2 [/SUP], Zhihai Han[SUP] 6 [/SUP], Jiguang Meng[SUP] 7 8 [/SUP], Weiguo Zhao[SUP] 1 [/SUP], Fei Xie[SUP] 9 [/SUP], Kaifei Wang[SUP] 9 [/SUP], Yuhong Liu[SUP] 1 [/SUP], Guoxin Muo[SUP] 1 [/SUP], Na Xi[SUP] 10 [/SUP], Mengli Zheng[SUP] 1 2 [/SUP], Rentao Wang[SUP] 1 2 [/SUP], Kun Xiao[SUP] 1 2 [/SUP], Wei Chen[SUP] 6 [/SUP], Junchen Xiong[SUP] 6 7 [/SUP], Dahui Zhao[SUP] 9 [/SUP], Xinxin Zhang[SUP] 1 [/SUP], Xinjie Han[SUP] 1 [/SUP], Haibo Cheng[SUP] 11 [/SUP], Zhongkuo Yu[SUP] 1 2 [/SUP], Yinghan Shi[SUP] 1 2 [/SUP], Wuxiang Xie[SUP] 12 13 [/SUP], Lixin Xie[SUP] 1 2 [/SUP]
Affiliations
- PMID: 38354691
- DOI: 10.1080/07853890.2024.2313062
Background: The effectiveness of nirmatrelvir-ritonavir has mainly been shown in non-hospitalized patients with mild-to-moderate coronavirus disease 2019 (COVID-19). The real-world effectiveness of nirmatrelvir-ritonavir urgently needs to be determined using representative in-hospital patients with COVID-19 during the Omicron wave of the pandemic.
Methods: We performed a multicentre, retrospective study in five Chinese PLA General Hospital medical centers in Beijing, China. Patients hospitalized with COVID-19 from 10 December 2022 to 20 February 2023 were eligible for inclusion. A 1:1 propensity score matching was performed between the nirmatrelvir-ritonavir group and the control group.
Results: 1010 recipients of nirmatrelvir-ritonavir and 1010 matched controls were finally analyzed after matching. Compared with matched controls, the nirmatrelvir-ritonavir group had a lower incidence rate of all-cause death (4.6/1000 vs. 6.3/1000 person-days, p = 0.013) and a higher incidence rate of clinical improvement (47.6/1000 vs. 45.8/1000 person-days, p = 0.012). Nirmatrelvir-ritonavir was associated with a 22% lower all-cause mortality and a 14% higher incidence of clinical improvement. Initiation of nirmatrelvir-ritonavir within 5 days after symptom onset was associated with a 50% lower mortality and a 26% higher clinical improvement rate. By contrast, no significant associations were identified among patients receiving nirmatrelvir-ritonavir treatment more than 5 days after symptom onset. Nirmatrelvir-ritonavir was also associated with a 50% increase in survival days and a 12% decrease in days to clinical improvement.
Conclusion: Among hospitalized patients with COVID-19 during the Omicron wave in Beijing, China, the early initiation of nirmatrelvir-ritonavir was associated with clinical benefits of lowering mortality and improving clinical recovery.
Keywords: Covid-19; all-cause death; clinical improvement; nirmatrelvir-ritonavir; off-label treatment; real-world.