Infectious Departments, Guizhou Provincial People's Hospital, Guizhou, China.
Department of Radiology, Guizhou Provincial People's Hospital, Guizhou, China.
Medicine (Baltimore). 2022 Nov 11;101(45):e31361. doi: 10.1097/MD.0000000000031361.
Paxlovid has shown the potential decreasing the hospitalization rate of mild or moderate coronavirus disease 2019 (COVID-19) and death in few of clinical trials, and is expected to the most promising medicine targeting Severe Acute Respiratory Syndrome Coronavirus 2 (SRAS-COV-2). However, there are no enough evidences to show it effectiveness for all patients with SARS-COV-2, especially among elderly patients and newest Omicron variant.
A 79 year's old female patient was admitted to hospital because of the moderate COVID-19 caused by the Omicron variant BA2.0. He presented the initial syndromes including Xerostomia, cough and fever. Chest computed tomography (CT) scanning at admission showed the exudation lesions on lung. The laboratory examination revealed that there are increased C-reactive protein (CRP), Ferritin and erythrocytesedimentationrate (ESR) and decreased white blood cells.
The oral Paxlovid (Nirmatrelvir/Ritonavir) was administrated on second day after admission.
The syndromes of Xerostomia, cough and fever was improved on third day after use of Paxlovid. The levels of CRP, ESR and counts of white blood cells returned the normal after three days of admission. The chest CT scanned on the third and sixth day after Paxlovid used showed the absorption of lesions. The examination of SARS-COVS viral nucleic acid turned negative at fifth day of admission.
As a result, we would consider that Paxlovid is a suitable oral drug for elderly patients with SARS-COV2 even Omicron variant, it's benefit to improve patient's symptom and signs and can prevents COVID-19 with the high-risk factors from severe disease, although it didn't shorten the time for viral nucleic acid to turn negative.
在几项临床试验中，Paxlovid 已显示出降低轻度或中度 2019 年冠状病毒病（COVID-19）住院率和死亡率的潜力，预计将成为针对严重急性呼吸系统综合征冠状病毒 2（SARS-COV-2）最有前途的药物。然而，尚无足够证据表明其对所有 SARS-COV-2 患者，特别是老年患者和最新的奥密克戎变异株都有效。
一名 79 岁女性患者因奥密克戎变异株 BA2.0 引起的中度 COVID-19 入院。她最初的症状包括口干、咳嗽和发热。入院时的胸部计算机断层扫描（CT）显示肺部有渗出性病变。实验室检查显示 C 反应蛋白（CRP）、铁蛋白和红细胞沉降率（ESR）升高，白细胞减少。
入院第二天开始口服 Paxlovid（奈玛特韦/利托那韦）。
使用 Paxlovid 第三天后，口干、咳嗽和发热症状改善。入院后三天，CRP、ESR 和白细胞计数恢复正常。入院第三天和第六天的胸部 CT 扫描显示病变吸收。入院第五天，SARS-COVS 病毒核酸检测转为阴性。
因此，我们认为即使是奥密克戎变异株，Paxlovid 也是老年 SARS-COV2 患者的一种合适的口服药物，它有利于改善患者的症状和体征，并能预防有高危因素的 COVID-19 发展为重症，尽管它不能缩短病毒核酸转为阴性的时间。
