tetano
Editor, Senior Moderator
Int J Antimicrob Agents
. 2023 Oct 26:107020.
doi: 10.1016/j.ijantimicag.2023.107020. Online ahead of print. Impact of pre-hospitalization use of oral antiviral agents on reducing critical illness and mortality for patients with COVID-19 pneumonia
Yong-Cheng Yii[SUP] 1 [/SUP], Hong-Mo Shih[SUP] 2 [/SUP], Chieh-Lung Chen[SUP] 3 [/SUP], Zi-Lun Lai[SUP] 4 [/SUP], Yu-Lung Hsu[SUP] 5 [/SUP], Chia-Hong Lai[SUP] 6 [/SUP], Po-Ren Hsueh[SUP] 7 [/SUP], Der-Yang Cho[SUP] 8 [/SUP]
Affiliations
This study aimed to evaluate the effect of administering nirmatrelvir/ritonavir and molnupiravir prior to hospitalization on subsequent critical illness among patients with coronavirus disease 2019 (COVID-19) pneumonia. This retrospective cohort study included patients with COVID-19 pneumonia who required hospitalization between January 1, 2022, and August 31, 2022. The primary outcomes were the development of critical illness, including intensive care unit admission, utilization of mechanical ventilation, or mortality. A multivariate logistic regression analysis was conducted to assess the varying risks of critical illness and mortality. A total of 1,011 COVID-19 patients were analyzed. Among them, 304 (30.1%) received molnupiravir and 131 (13.0%) received nirmatrelvir/ritonavir before hospitalization. There were significant reductions for critical illness (adjusted odds ratio [aOR] 0.29, 95% confidence interval [CI] 0.21-0.39, p<0.001) and mortality (aOR 0.40, 95% CI 0.27-0.59, p<0.001) in patients receiving oral antivirals compared to those who did not. No significant differences in critical illness were observed between molnupiravir and nirmatrelvir/ritonavir. The combination of COVID-19 vaccines and oral antivirals can further reduce the risk of critical illness in high-risk populations. In conclusion, administering molnupiravir and nirmatrelvir/ritonavir before hospitalization reduced the risk of COVID-19 patients with moderate to severe pneumonia progressing to critical illness and mortality.
Keywords: COVID-19; Critical illness; Molnupiravir; Nirmatrelvir/ritonavir; Oral antivirals; Vaccine.
. 2023 Oct 26:107020.
doi: 10.1016/j.ijantimicag.2023.107020. Online ahead of print. Impact of pre-hospitalization use of oral antiviral agents on reducing critical illness and mortality for patients with COVID-19 pneumonia
Yong-Cheng Yii[SUP] 1 [/SUP], Hong-Mo Shih[SUP] 2 [/SUP], Chieh-Lung Chen[SUP] 3 [/SUP], Zi-Lun Lai[SUP] 4 [/SUP], Yu-Lung Hsu[SUP] 5 [/SUP], Chia-Hong Lai[SUP] 6 [/SUP], Po-Ren Hsueh[SUP] 7 [/SUP], Der-Yang Cho[SUP] 8 [/SUP]
Affiliations
- PMID: 37898365
- DOI: 10.1016/j.ijantimicag.2023.107020
This study aimed to evaluate the effect of administering nirmatrelvir/ritonavir and molnupiravir prior to hospitalization on subsequent critical illness among patients with coronavirus disease 2019 (COVID-19) pneumonia. This retrospective cohort study included patients with COVID-19 pneumonia who required hospitalization between January 1, 2022, and August 31, 2022. The primary outcomes were the development of critical illness, including intensive care unit admission, utilization of mechanical ventilation, or mortality. A multivariate logistic regression analysis was conducted to assess the varying risks of critical illness and mortality. A total of 1,011 COVID-19 patients were analyzed. Among them, 304 (30.1%) received molnupiravir and 131 (13.0%) received nirmatrelvir/ritonavir before hospitalization. There were significant reductions for critical illness (adjusted odds ratio [aOR] 0.29, 95% confidence interval [CI] 0.21-0.39, p<0.001) and mortality (aOR 0.40, 95% CI 0.27-0.59, p<0.001) in patients receiving oral antivirals compared to those who did not. No significant differences in critical illness were observed between molnupiravir and nirmatrelvir/ritonavir. The combination of COVID-19 vaccines and oral antivirals can further reduce the risk of critical illness in high-risk populations. In conclusion, administering molnupiravir and nirmatrelvir/ritonavir before hospitalization reduced the risk of COVID-19 patients with moderate to severe pneumonia progressing to critical illness and mortality.
Keywords: COVID-19; Critical illness; Molnupiravir; Nirmatrelvir/ritonavir; Oral antivirals; Vaccine.