Bhatia Abhishek, Preiss Alexander J, Xiao Xuya, Brannock M Daniel, Alexander G Caleb, Chew Robert F, Fitzgerald Megan, Hill Elaine, Kelly Elizabeth P, Mehta Hemalkumar B, Madlock-Brown Charisse, Wilkins Kenneth J, Chute Christopher G, Haendel Melissa, Moffitt Richard, Pfaff Emily R
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
RTI International, Durham, NC, USA.
medRxiv. 2023 May 4:2023.05.03.23289084. doi: 10.1101/2023.05.03.23289084.
This study leverages electronic health record data in the National COVID Cohort Collaborative's (N3C) repository to investigate disparities in Paxlovid treatment and to emulate a target trial assessing its effectiveness in reducing COVID-19 hospitalization rates. From an eligible population of 632,822 COVID-19 patients seen at 33 clinical sites across the United States between December 23, 2021 and December 31, 2022, patients were matched across observed treatment groups, yielding an analytical sample of 410,642 patients. We estimate a 65% reduced odds of hospitalization among Paxlovid-treated patients within a 28-day follow-up period, and this effect did not vary by patient vaccination status. Notably, we observe disparities in Paxlovid treatment, with lower rates among Black and Hispanic or Latino patients, and within socially vulnerable communities. Ours is the largest study of Paxlovid's real-world effectiveness to date, and our primary findings are consistent with previous randomized control trials and real-world studies.
本研究利用国家新冠队列协作组（N3C）数据库中的电子健康记录数据，调查帕罗韦德治疗方面的差异，并模拟一项评估其降低新冠住院率有效性的目标试验。在2021年12月23日至2022年12月31日期间，从美国33个临床地点的632,822名新冠患者的合格人群中，对观察到的治疗组患者进行匹配，得到了410,642名患者的分析样本。我们估计，在28天的随访期内，接受帕罗韦德治疗的患者住院几率降低了65%，且这一效果不因患者疫苗接种状况而有所不同。值得注意的是，我们观察到帕罗韦德治疗存在差异，黑人和西班牙裔或拉丁裔患者以及社会弱势群体中的治疗率较低。我们的研究是迄今为止关于帕罗韦德真实世界有效性的最大规模研究，我们的主要发现与之前的随机对照试验和真实世界研究一致。
