tetano
Editor, Senior Moderator
Nat Commun
. 2024 Jun 8;15(1):4917.
doi: 10.1038/s41467-024-49235-8. Effectiveness of nirmatrelvir/ritonavir in children and adolescents aged 12-17 years following SARS-CoV-2 Omicron infection: A target trial emulation
Carlos K H Wong[SUP] #[/SUP][SUP] 1 2 3 4 [/SUP], Kristy T K Lau[SUP] #[/SUP][SUP] 5 [/SUP], Ivan C H Au[SUP] #[/SUP][SUP] 5 6 [/SUP], Sophelia H S Chan[SUP] 7 [/SUP], Eric H Y Lau[SUP] 8 9 [/SUP], Benjamin J Cowling[SUP] 8 9 [/SUP], Gabriel M Leung[SUP] 8 9 [/SUP]
Affiliations
Currently there is a lack of randomized trial data examining the use of the antiviral nirmatrelvir/ritonavir in paediatric patients with SARS-CoV-2 infection. This target trial emulation study aims to address this gap by evaluating the use of nirmatrelvir/ritonavir in non-hospitalized paediatric patients aged 12-17 years with SARS-CoV-2 Omicron variant infection. Among paediatric patients diagnosed between 16th March 2022 and 5th February 2023, exposure was defined as outpatient nirmatrelvir/ritonavir treatment within 5 days of symptom onset or COVID-19 diagnosis. Primary outcome was 28 day all-cause mortality or all-cause hospitalization, while secondary outcomes were 28 day in-hospital disease progression, 28 day COVID-19-specific hospitalization, multisystem inflammatory syndrome in children (MIS-C), acute liver injury, acute renal failure, and acute respiratory distress syndrome. Overall, 49,378 eligible paediatric patients were included. Nirmatrelvir/ritonavir treatment was associated with reduced 28 day all-cause hospitalization (absolute risk reduction = 0.23%, 95%CI = 0.19%-0.31%; relative risk = 0.66, 95%CI = 0.56-0.71). No events of mortality, in-hospital disease progression, or adverse clinical outcomes were observed among nirmatrelvir/ritonavir users. The findings confirmed the effectiveness of nirmatrelvir/ritonavir in reducing all-cause hospitalization risk among non-hospitalized pediatric patients with SARS-CoV-2 Omicron variant infection.
. 2024 Jun 8;15(1):4917.
doi: 10.1038/s41467-024-49235-8. Effectiveness of nirmatrelvir/ritonavir in children and adolescents aged 12-17 years following SARS-CoV-2 Omicron infection: A target trial emulation
Carlos K H Wong[SUP] #[/SUP][SUP] 1 2 3 4 [/SUP], Kristy T K Lau[SUP] #[/SUP][SUP] 5 [/SUP], Ivan C H Au[SUP] #[/SUP][SUP] 5 6 [/SUP], Sophelia H S Chan[SUP] 7 [/SUP], Eric H Y Lau[SUP] 8 9 [/SUP], Benjamin J Cowling[SUP] 8 9 [/SUP], Gabriel M Leung[SUP] 8 9 [/SUP]
Affiliations
- PMID: 38851796
- PMCID: PMC11162460
- DOI: 10.1038/s41467-024-49235-8
Currently there is a lack of randomized trial data examining the use of the antiviral nirmatrelvir/ritonavir in paediatric patients with SARS-CoV-2 infection. This target trial emulation study aims to address this gap by evaluating the use of nirmatrelvir/ritonavir in non-hospitalized paediatric patients aged 12-17 years with SARS-CoV-2 Omicron variant infection. Among paediatric patients diagnosed between 16th March 2022 and 5th February 2023, exposure was defined as outpatient nirmatrelvir/ritonavir treatment within 5 days of symptom onset or COVID-19 diagnosis. Primary outcome was 28 day all-cause mortality or all-cause hospitalization, while secondary outcomes were 28 day in-hospital disease progression, 28 day COVID-19-specific hospitalization, multisystem inflammatory syndrome in children (MIS-C), acute liver injury, acute renal failure, and acute respiratory distress syndrome. Overall, 49,378 eligible paediatric patients were included. Nirmatrelvir/ritonavir treatment was associated with reduced 28 day all-cause hospitalization (absolute risk reduction = 0.23%, 95%CI = 0.19%-0.31%; relative risk = 0.66, 95%CI = 0.56-0.71). No events of mortality, in-hospital disease progression, or adverse clinical outcomes were observed among nirmatrelvir/ritonavir users. The findings confirmed the effectiveness of nirmatrelvir/ritonavir in reducing all-cause hospitalization risk among non-hospitalized pediatric patients with SARS-CoV-2 Omicron variant infection.