Department of Pharmacy, Nguyen Tat Thanh University, 72820, HCMC, Vietnam.
Department of Surgical Gastroenterology, Nhan Dan Gia Dinh Hospital, 72316, HCMC, Vietnam.
BMC Infect Dis. 2024 Jan 2;24(1):25. doi: 10.1186/s12879-023-08952-z.
Antivirals have been given widely for patients with COVID-19 breakthrough in Asian countries, creating a "black market" for unapproved and unprescribed medications. More evidence is needed to clarify the benefits of antivirals in these settings.
We conducted a random-sampling retrospective cohort study at a general hospital in Vietnam. We recruited patients with mild-to-moderate COVID-19 breakthrough who were given either standard of care (SoC) alone or SoC + antiviral. Primary outcome was residual respiratory symptoms that lasted > 7 days. Secondary outcome was long COVID-19, diagnosed by specialized physicians. We used logistic regression to measure odds ratio (OR), in addition to a sensitivity and subgroup analyses to further explore the results.
A total of 142 patients (mean age 36.2 ± 9.8) were followed. We recorded residual symptoms in 27.9% and 20.3% of the SoC and SoC + antiviral group, while the figures for long COVID-19 were 11.8% and 8.1%, respectively. Antiviral use was not significantly associated with lower the risks of residual symptoms (OR = 0.51, 95% CI: 0.22-1.20, p = 0.12) or long COVID-19 (OR = 0.55, 95% CI: 0.16-1.90, p = 0.35). The sensitivity and subgroup analyses did not show any significant differences between the study groups (all p > 0.05).
Antivirals were not associated with faster resolution of respiratory symptoms or lower risks of long COVID-19. Further studies should focus on different antivirals to confirm their effects on different sub-populations. Meanwhile, antivirals should only be used in very high-risk patients to avoid excessive costs and harms.
在亚洲国家，针对 COVID-19 突破性感染的患者广泛使用了抗病毒药物，这导致了未经批准和处方的药物的“黑市”。需要更多的证据来明确这些环境下抗病毒药物的益处。
我们在越南的一家综合医院进行了一项随机抽样回顾性队列研究。我们招募了患有轻度至中度 COVID-19 突破性感染且接受标准治疗（SoC）或 SoC+抗病毒药物治疗的患者。主要结局是持续>7 天的残留呼吸道症状。次要结局是由专科医生诊断的长新冠。我们使用逻辑回归来衡量比值比（OR），并进行敏感性和亚组分析以进一步探讨结果。
共随访了 142 例患者（平均年龄 36.2±9.8 岁）。SoC 组和 SoC+抗病毒药物组的残留症状分别为 27.9%和 20.3%，长新冠的比例分别为 11.8%和 8.1%。抗病毒药物的使用与残留症状（OR=0.51，95%CI：0.22-1.20，p=0.12）或长新冠（OR=0.55，95%CI：0.16-1.90，p=0.35）的风险降低无关。敏感性和亚组分析均未显示两组之间存在显著差异（均 p>0.05）。
抗病毒药物与呼吸道症状的更快缓解或长新冠的风险降低无关。进一步的研究应侧重于不同的抗病毒药物，以确认它们对不同亚人群的影响。同时，应仅将抗病毒药物用于高危患者，以避免过度的成本和危害。
