奈玛特韦-利托那韦对感染 SARS-CoV-2 奥密克戎变异株患者的病毒清除和住院时间的影响。
The effect of nirmatrelvir-ritonavir on viral clearance and length of hospital stay in patients infected with SARS-CoV-2 omicron variants.
机构信息
Department of Cardiology, Shidong Hospital, Yangpu District, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, Shanghai, China.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Influenza Other Respir Viruses. 2023 Feb;17(2):e13095. doi: 10.1111/irv.13095.
BACKGROUND
The pandemic of coronavirus disease 2019 (COVID-19) has caused heavy burdens on national healthcare systems. Nirmatrelvir-ritonavir (Paxlovid) may be one of the most promising therapeutic drugs, with reports of up to 89% reduction rates in hospitalization risk and death among patients with mild-to-moderate COVID-19 who are at risk of developing severe disease. However, limited studies have investigated the effects of this class of drugs on viral clearance and length of hospital stay.
METHODS
In this study, we retrospectively analyzed the characteristics of patients infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and investigated the effects of oral nirmatrelvir-ritonavir on viral clearance and length of hospital stay in mild-to-moderate COVID-19 patients at high risk for progression to severe disease.
RESULTS
The median SARS-CoV-2 negative conversion time was 16 (13-20) versus 13 (10-16) days (control group versus nirmatrelvir-ritonavir group, p < 0.001), the median length of hospital stay was 13 (10-16) versus 12 (13-14) days (control group versus nirmatrelvir-ritonavir group, p = 0.01), and the SARS-CoV-2 negative conversion time and length of hospital stay were significantly shorter in the nirmatrelvir-ritonavir group than in the control group. When controlling for hypertension, chronic kidney disease, severity status of COVID-19, use of antibiotic agent, and COVID-19 vaccine received, multiple stepwise linear regression analysis showed that nirmatrelvir-ritonavir treatment was negatively associated with the SARS-CoV-2 negative conversion time and length of hospital stay.
CONCLUSION
Nirmatrelvir-ritonavir reduces the viral clearance time and length of hospital stay in hospitalized patients with COVID-19. Nirmatrelvir-ritonavir might be a promising drug to reduce the virus load and the heavy burden of healthcare systems.
背景
2019 年冠状病毒病（COVID-19）大流行给各国的医疗体系带来了沉重的负担。尼马曲韦-利托那韦（Paxlovid）可能是最有前途的治疗药物之一，有报道称，对于有发展为重症风险的 COVID-19 轻症至中度患者，住院风险和死亡风险降低了高达 89%。然而，有限的研究调查了这类药物对病毒清除和住院时间的影响。
方法
在这项研究中，我们回顾性分析了感染 SARS-CoV-2 奥密克戎变异株的患者的特征，并调查了口服尼马曲韦-利托那韦对有进展为重症风险的 COVID-19 轻症至中度患者的病毒清除和住院时间的影响。
结果
SARS-CoV-2 转阴时间的中位数为 16（13-20）天与 13（10-16）天（对照组与尼马曲韦-利托那韦组，p<0.001），住院时间的中位数为 13（10-16）天与 12（13-14）天（对照组与尼马曲韦-利托那韦组，p=0.01），尼马曲韦-利托那韦组的 SARS-CoV-2 转阴时间和住院时间均显著短于对照组。在控制了高血压、慢性肾脏病、COVID-19 严重程度、抗生素使用和接种的 COVID-19 疫苗后，多步线性回归分析显示，尼马曲韦-利托那韦治疗与 SARS-CoV-2 转阴时间和住院时间呈负相关。
结论
尼马曲韦-利托那韦缩短了 COVID-19 住院患者的病毒清除时间和住院时间。尼马曲韦-利托那韦可能是一种有前途的降低病毒载量和减轻医疗体系负担的药物。
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