Nursing Department, First Hospital of Jilin University, Changchun, China.
Department of Hepatobiliary and Pancreatic Surgery, First Hospital of Jilin University, Changchun, China.
Clin Infect Dis. 2023 Feb 8;76(3):e148-e154. doi: 10.1093/cid/ciac600.
Acceleration of negative respiratory conversion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with coronavirus disease 2019 (COVID-19) might reduce viral transmission. Nirmatrelvir/ritonavir is a new antiviral agent recently approved for treatment of COVID-19 that has the potential to facilitate negative conversion.
A cohort of hospitalized adult patients with mild-to-moderate COVID-19 who had a high risk for progression to severe disease were studied. These patients presented with COVID-19 symptoms between 5 March and 5 April 2022. The time from positive to negative upper respiratory reverse transcription-polymerase chain reaction (RT-PCR) conversion was assessed by Kaplan-Meier plots and Cox proportional hazards regression with the adjustment for patients' baseline demographic and clinical characteristics.
There were 258 patients treated with nirmatrelvir/ritonavir and 224 nontreated patients who had mild-to-moderate COVID-19. The median (interquartile range) time for patients who converted from positive to negative RT-PCR was 10 days (7-12 days) in patients treated ≤5 days after symptom onset and 17 days (12-21 days) in nontreated patients. The proportions of patients with a negative conversion at day 15 were 89.7% and 42.0% in treated patients and nontreated patients, corresponding to a hazard ratio of 4.33 (95% confidence interval, 3.31-5.65). Adjustment for baseline differences between the groups had little effect on the association. Subgroup analysis on treated patients suggests that time to negative conversion did not vary with the patients' baseline characteristics.
This cohort study of high-risk patients with mild-to-moderate COVID-19 found an association between nirmatrelvir/ritonavir treatment and accelerated negative RT-PCR respiratory SARS-CoV-2 conversion that might reduce the risk of viral shedding and disease transmission.
加速 2019 冠状病毒病（COVID-19）患者严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的负性呼吸转换，可能会降低病毒传播。奈玛特韦/利托那韦是一种新的抗病毒药物，最近被批准用于治疗 COVID-19，具有促进负性转换的潜力。
研究了一组患有轻度至中度 COVID-19、有进展为重症疾病高风险的住院成年患者。这些患者于 2022 年 3 月 5 日至 4 月 5 日出现 COVID-19 症状。通过 Kaplan-Meier 图和 Cox 比例风险回归，调整患者的基线人口统计学和临床特征，评估从阳性到阴性上呼吸道逆转录-聚合酶链反应（RT-PCR）转换的时间。
有 258 例患者接受了奈玛特韦/利托那韦治疗，224 例未接受治疗的患者患有轻度至中度 COVID-19。在症状出现后≤5 天接受治疗的患者中，从阳性转为阴性 RT-PCR 的中位（四分位距）时间为 10 天（7-12 天），而未接受治疗的患者为 17 天（12-21 天）。在第 15 天，接受治疗的患者中有 89.7%和未接受治疗的患者中有 42.0%的患者转为阴性，相应的风险比为 4.33（95%置信区间，3.31-5.65）。对两组间基线差异的调整对该关联影响不大。对接受治疗的患者进行亚组分析表明，阴性转换的时间与患者的基线特征无关。
这项对患有轻度至中度 COVID-19 的高危患者的队列研究发现，奈玛特韦/利托那韦治疗与加速 SARS-CoV-2 的阴性 RT-PCR 呼吸道转换有关，这可能降低病毒脱落和疾病传播的风险。
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