Karniadakis Ioannis, Mazonakis Nikolaos, Tsioutis Constantinos, Papadakis Michail, Markaki Ioulia, Spernovasilis Nikolaos
Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK.
Internal Medicine Department, Thoracic Diseases General Hospital Sotiria, 11527 Athens, Greece.
Infect Dis Rep. 2023 Oct 25;15(6):662-678. doi: 10.3390/idr15060061.
Vaccines remain the cornerstone of medical prevention and are highly effective in reducing the risk of severe disease and death due to coronavirus disease 2019 (COVID-19). In the context of expanding the therapeutic armamentarium against COVID-19, molnupiravir (Lagevrio) and ritonavir-boosted nirmatrelvir (Paxlovid) were developed, constituting the first effective oral treatments against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this narrative review, we retrospectively inquired into the clinical trials and real-world studies investigating the efficacy of these agents. Overall, clinical trials and real-world studies have demonstrated the efficacy of both agents in reducing hospitalization and death rates in COVID-19 patients. As per current recommendations, their use is suggested in patients with mild to moderate symptoms who are at high risk of developing severe disease. Nevertheless, limited data exist regarding their efficacy in specific subpopulations, such as immunocompromised patients, those with severe kidney disease, pregnant women, and children.
疫苗仍然是医学预防的基石，在降低2019冠状病毒病（COVID-19）导致的重症和死亡风险方面非常有效。在扩大针对COVID-19的治疗手段的背景下，开发了莫努匹拉韦（Lagevrio）和利托那韦增强的奈玛特韦（Paxlovid），它们构成了首批针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的有效口服治疗药物。在这篇叙述性综述中，我们回顾性地探究了调查这些药物疗效的临床试验和真实世界研究。总体而言，临床试验和真实世界研究均已证明这两种药物在降低COVID-19患者的住院率和死亡率方面的疗效。根据当前建议，建议在有发展为重症高风险的轻至中度症状患者中使用这些药物。然而，关于它们在特定亚人群中的疗效数据有限，如免疫功能低下患者、严重肾病患者、孕妇和儿童。
