tetano
Editor, Senior Moderator
BMC Infect Dis
. 2025 Feb 25;25(1):275.
doi: 10.1186/s12879-025-10643-w. Real-world effectiveness and safety of oral Azvudine versus Paxlovid for COVID-19 in patients with kidney disease: a multicenter, retrospective, cohort study
Benchen Rao[SUP] #[/SUP][SUP] 1 [/SUP], Daming Wang[SUP] #[/SUP][SUP] 1 [/SUP], Mengzhao Yang[SUP] 1 [/SUP], Chunyu Zhao[SUP] 1 [/SUP], Ming Cheng[SUP] 2 [/SUP], Silin Li[SUP] 3 [/SUP], Donghua Zhang[SUP] 4 [/SUP], Hong Luo[SUP] 5 [/SUP], Guowu Qian[SUP] 6 [/SUP], Ling Wang[SUP] 7 [/SUP], Shixi Zhang[SUP] 8 [/SUP], Guotao Li[SUP] 9 [/SUP], Guangming Li[SUP] 10 [/SUP], Zujiang Yu[SUP] 11 [/SUP], Zhigang Ren[SUP] 12 [/SUP]
Affiliations
Background: Patients with kidney disease (KD) are at high risk of contracting COVID-19 and developing severe disease. There is still a lack of guidance regarding the treatment of COVID-19 in patients with KD. The safety and effectiveness of Azvudine in treating COVID-19 patients with KD remain unknown.
Methods: This study included 32,864 COVID-19 patients from nine centers in Henan Province, China. After applying the exclusion criteria and 2:1 propensity score matching, 438 and 219 participants in the Azvudine and Paxlovid groups, respectively, were subjected to analysis.
Results: Kaplan-Meier analysis revealed no significant differences in all-cause death or composite disease progression between the Azvudine and Paxlovid groups (all p values > 0.05). The same results were obtained in the Cox regression analysis after baseline characteristics adjustment. Three different sensitivity analyses contributed to the robustness of these findings. Subgroup analysis revealed that patients treated with Azvudine had a lower risk of composite disease progression than patients treated with Paxlovid did among patients with moderate disease (p = 0.016, HR: 0.51, 95% CI: 0.27-0.96). Safety data indicated that there was no difference in the incidence of most adverse events. Compared with the Paxlovid group, the Azvudine group had a lower incidence of hypophosphatemia (p = 0.008) and a lower PLT count (p = 0.045). Moreover, during the 15-day follow-up since drug administration, higher concentrations of lymphocytes were detected in the Azvudine group.
Conclusions: This study is the first to report that the safety and effectiveness of Azvudine are not inferior to those of Paxlovid in COVID-19 patients with KD. This study provides additional treatment options for COVID-19 patients with KD.
Keywords: Azvudine; COVID-19; Effectiveness; Kidney diseases; Paxlovid; Real-world; Safety.
. 2025 Feb 25;25(1):275.
doi: 10.1186/s12879-025-10643-w. Real-world effectiveness and safety of oral Azvudine versus Paxlovid for COVID-19 in patients with kidney disease: a multicenter, retrospective, cohort study
Benchen Rao[SUP] #[/SUP][SUP] 1 [/SUP], Daming Wang[SUP] #[/SUP][SUP] 1 [/SUP], Mengzhao Yang[SUP] 1 [/SUP], Chunyu Zhao[SUP] 1 [/SUP], Ming Cheng[SUP] 2 [/SUP], Silin Li[SUP] 3 [/SUP], Donghua Zhang[SUP] 4 [/SUP], Hong Luo[SUP] 5 [/SUP], Guowu Qian[SUP] 6 [/SUP], Ling Wang[SUP] 7 [/SUP], Shixi Zhang[SUP] 8 [/SUP], Guotao Li[SUP] 9 [/SUP], Guangming Li[SUP] 10 [/SUP], Zujiang Yu[SUP] 11 [/SUP], Zhigang Ren[SUP] 12 [/SUP]
Affiliations
- PMID: 40001043
- PMCID: PMC11863899
- DOI: 10.1186/s12879-025-10643-w
Background: Patients with kidney disease (KD) are at high risk of contracting COVID-19 and developing severe disease. There is still a lack of guidance regarding the treatment of COVID-19 in patients with KD. The safety and effectiveness of Azvudine in treating COVID-19 patients with KD remain unknown.
Methods: This study included 32,864 COVID-19 patients from nine centers in Henan Province, China. After applying the exclusion criteria and 2:1 propensity score matching, 438 and 219 participants in the Azvudine and Paxlovid groups, respectively, were subjected to analysis.
Results: Kaplan-Meier analysis revealed no significant differences in all-cause death or composite disease progression between the Azvudine and Paxlovid groups (all p values > 0.05). The same results were obtained in the Cox regression analysis after baseline characteristics adjustment. Three different sensitivity analyses contributed to the robustness of these findings. Subgroup analysis revealed that patients treated with Azvudine had a lower risk of composite disease progression than patients treated with Paxlovid did among patients with moderate disease (p = 0.016, HR: 0.51, 95% CI: 0.27-0.96). Safety data indicated that there was no difference in the incidence of most adverse events. Compared with the Paxlovid group, the Azvudine group had a lower incidence of hypophosphatemia (p = 0.008) and a lower PLT count (p = 0.045). Moreover, during the 15-day follow-up since drug administration, higher concentrations of lymphocytes were detected in the Azvudine group.
Conclusions: This study is the first to report that the safety and effectiveness of Azvudine are not inferior to those of Paxlovid in COVID-19 patients with KD. This study provides additional treatment options for COVID-19 patients with KD.
Keywords: Azvudine; COVID-19; Effectiveness; Kidney diseases; Paxlovid; Real-world; Safety.