MMWR Morb Mortal Wkly Rep. 2022 Dec 2;71(48):1531-1537. doi: 10.15585/mmwr.mm7148e2.
Nirmatrelvir-ritonavir (Paxlovid), an oral antiviral treatment, is authorized for adults with mild-to-moderate COVID-19 who are at increased risk for progression to severe illness. However, real-world evidence on the benefit of Paxlovid, according to vaccination status, age group, and underlying health conditions, is limited. To examine the benefit of Paxlovid in adults aged ≥18 years in the United States, a large electronic health record (EHR) data set (Cosmos) was analyzed to assess the association between receiving a prescription for Paxlovid and hospitalization with a COVID-19 diagnosis in the ensuing 30 days. A Cox proportional hazards model was used to estimate this association, adjusted for demographic characteristics, geographic location, vaccination, previous infection, and number of underlying health conditions. Among 699,848 adults aged ≥18 years eligible for Paxlovid during April-August 2022, 28.4% received a Paxlovid prescription within 5 days of COVID-19 diagnosis. Being prescribed Paxlovid was associated with a lower hospitalization rate among the overall study population (adjusted hazard ratio [aHR] = 0.49), among those who had received ≥3 mRNA COVID-19 vaccines (aHR = 0.50), and across age groups (18-49 years: aHR = 0.59; 50-64 years: aHR = 0.40; and ≥65 years: aHR = 0.53). Paxlovid should be prescribed to eligible adults to reduce the risk of COVID-19-associated hospitalization.
尼马瑞韦/利托那韦（奈玛特韦/利托那韦片，Paxlovid）是一种口服抗病毒治疗药物，被授权用于患有轻度至中度 COVID-19 的成年人，这些人有进展为重症的高风险。然而，根据疫苗接种状况、年龄组和潜在健康状况，关于奈玛特韦/利托那韦片的实际效果的证据有限。为了研究美国≥18 岁成年人使用奈玛特韦/利托那韦片的获益，对一个大型电子健康记录（EHR）数据集（Cosmos）进行了分析，以评估开具奈玛特韦/利托那韦片处方与随后 30 天内 COVID-19 诊断相关住院之间的关联。使用 Cox 比例风险模型来估计这种关联，调整了人口统计学特征、地理位置、疫苗接种、既往感染和潜在健康状况的数量。在 2022 年 4 月至 8 月期间有资格接受奈玛特韦/利托那韦片治疗的 699848 名≥18 岁成年人中，有 28.4%在 COVID-19 诊断后 5 天内开具了奈玛特韦/利托那韦片处方。在整个研究人群中（调整后的危险比[aHR] = 0.49）、在接种≥3 剂 mRNA COVID-19 疫苗的人群中（aHR = 0.50）以及在各年龄组（18-49 岁：aHR = 0.59；50-64 岁：aHR = 0.40；≥65 岁：aHR = 0.53）中，开具奈玛特韦/利托那韦片处方与较低的住院率相关。应向符合条件的成年人开具奈玛特韦/利托那韦片处方，以降低 COVID-19 相关住院的风险。
