奈玛特韦/利托那韦在 COVID-19 大流行真实世界数据中的抗病毒效果。
The Antiviral Effect of Nirmatrelvir/Ritonavir during COVID-19 Pandemic Real-World Data.
机构信息
Department of Infectious Diseases, 2nd University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University Thrace, 68132 Alexandroupolis, Greece.
Department of Medical Statistics, Medical School, Democritus University of Thrace, 69100 Komotini, Greece.
出版信息
Viruses. 2023 Apr 16;15(4):976. doi: 10.3390/v15040976.
INTRODUCTION
Vaccination against SARS-CoV-2 and the prevalence of Omicron variants have reduced the risk of the severe clinical progress of COVID-19. However, the risk of breakthrough infections has increased, and early administration of an effective antiviral treatment is significant in order to prevent the severe progression of COVID-19 in vulnerable patients with comorbidities.
PATIENTS AND METHODS
Adults with confirmed SARS-CoV-2 infection were included in a matched-pair retrospective study based on age, gender, comorbidities and vaccination status. They were divided into two groups: group A (n = 200) consisted of outpatients at increased risk of severe clinical progress who were treated with nirmatrelvir/ritonavir and group B (n = 200) consisted of non-hospitalized patients who did not receive antiviral treatment. Demographic data, clinical outcome (death, intubation), days of hospitalization, time for recovery, adverse events and treatment compliance were reported.
RESULTS
The median age (75.24 ± 13.12 years in the study group and 76.91 ± 14.02 years in the comparison group) and the proportion of males (59% vs. 60.5%, respectively) were similar between the two groups. A total of 6.5% of patients in group A and 10.5% in group B were unvaccinated against SARS-CoV-2. Three patients from group A (1.5%) and one hundred eleven (55.5%) from group B required hospitalization. The duration of hospitalization (3 days vs. 10 days in group B, < 0.001) and the total time needed for recovery (5 days vs. 9 days, < 0.001) was shorter in the study group. A rebound of SARS-CoV-2 infection within 8-12 days after diagnosis was documented in 6.5% of patients in group A and 8% of patients in group B.
CONCLUSION
Oral treatment with nirmatrelvir/ritonavir in high-risk non-hospitalized patients was safe and effective in preventing the severe clinical progress of COVID-19 pneumonia. Early administration of antiviral agents in vulnerable outpatients combined with a full vaccination scheme is significant in order to avoid hospitalization and severe clinical outcomes.
简介
接种 SARS-CoV-2 疫苗和奥密克戎变异株的流行降低了 COVID-19 严重临床进展的风险。然而，突破性感染的风险增加了，对于有合并症的脆弱患者，早期使用有效的抗病毒治疗对于预防 COVID-19 的严重进展非常重要。
患者和方法
本回顾性配对研究纳入了确诊的 SARS-CoV-2 感染的成年人，根据年龄、性别、合并症和疫苗接种状态进行分组。他们被分为两组：A 组（n = 200）由有发生严重临床进展风险的门诊患者组成，接受奈玛特韦/利托那韦治疗；B 组（n = 200）由未接受抗病毒治疗的非住院患者组成。报告了人口统计学数据、临床结局（死亡、插管）、住院天数、康复时间、不良事件和治疗依从性。
结果
两组的中位年龄（研究组 75.24 ± 13.12 岁，对照组 76.91 ± 14.02 岁）和男性比例（分别为 59%和 60.5%）相似。A 组有 6.5%的患者和 B 组有 10.5%的患者未接种 SARS-CoV-2 疫苗。A 组有 3 名患者（1.5%）和 B 组有 111 名患者（55.5%）需要住院治疗。A 组的住院时间（3 天 vs. B 组的 10 天， < 0.001）和总康复时间（5 天 vs. B 组的 9 天， < 0.001）均较短。在诊断后 8-12 天内，A 组有 6.5%的患者和 B 组有 8%的患者出现 SARS-CoV-2 感染反弹。
结论
在高危非住院患者中使用奈玛特韦/利托那韦进行口服治疗，可安全有效地预防 COVID-19 肺炎的严重临床进展。对于脆弱的门诊患者，早期使用抗病毒药物并结合全面的疫苗接种方案，对于避免住院和严重的临床结局非常重要。
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