Department of Infectious Disease, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University (The First Hospital of Changsha), Changsha, 410000, People's Republic of China.
Department of Respiratory and Critical Care Medicine, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University (The First Hospital of Changsha), Changsha, 410000, People's Republic of China.
Sci Rep. 2024 Feb 9;14(1):3318. doi: 10.1038/s41598-024-53862-y.
This study aimed to explore the effectiveness and safety of azvudine, nirmatrelvir/ritonavir, and molnupiravir in adult patients with mild-to-moderate COVID-19. This retrospective cohort study included patients with mild-to-moderate COVID-19 (asymptomatic, mild, and common types) at the First Hospital of Changsha (Hunan Province, China) between March and November 2022. Eligible patients were classified into the azvudine, nirmatrelvir/ritonavir, or molnupiravir groups according to the antiviral agents they received. The outcomes were the times to nucleic acid negative conversion (NANC). This study included 157 patients treated with azvudine (n = 66), molnupiravir (n = 66), or nirmatrelvir/ritonavir (n = 25). There were no statistically significant differences in the time from diagnosis to NANC among the azvudine, molnupiravir, and nirmatrelvir/ritonavir groups [median, 9 (95% CI 9-11) vs. 11 (95% CI 10-12) vs. 9 (95% CI 8-12) days, P = 0.15], time from administration to NANC [median, 9 (95% CI 8-10) vs. 10 (95% CI 9.48-11) vs. 8.708 (95% CI 7.51-11) days, P = 0.50], or hospital stay [median, 11 (95% CI 11-13) vs. 13 (95% CI 12-14) vs. 12 (95% CI 10-14) days, P = 0.14], even after adjustment for sex, age, COVID-19 type, comorbidities, Ct level, time from diagnosis to antiviral treatment, and number of symptoms. The cumulative NANC rates in the azvudine, molnupiravir, and nirmatrelvir/ritonavir groups were 15.2%/12.3%/16.0% at day 5 (P = 0.858), 34.8%/21.5%/32.0% at day 7 (P = 0.226), 66.7%/52.3%/60.0% at 10 days (P = 0.246), and 86.4%/86.2%/80.0% at day 14 (P = 0.721). No serious adverse events were reported. Azvudine may be comparable to nirmatrelvir/ritonavir and molnupiravir in adult patients with mild-to-moderate COVID-19 regarding time to NANC, hospital stay, and AEs.
本研究旨在探索阿兹夫定、奈玛特韦/利托那韦和莫努匹韦在轻至中度 COVID-19 成年患者中的疗效和安全性。这是一项回顾性队列研究，纳入了 2022 年 3 月至 11 月期间在中国湖南省长沙市第一医院收治的轻至中度 COVID-19（无症状、轻症和普通型）患者。根据接受的抗病毒药物，将符合条件的患者分为阿兹夫定、奈玛特韦/利托那韦或莫努匹韦组。结局为核酸转阴（NANC）时间。该研究纳入了 157 名接受阿兹夫定（n=66）、莫努匹韦（n=66）或奈玛特韦/利托那韦（n=25）治疗的患者。阿兹夫定、莫努匹韦和奈玛特韦/利托那韦组从诊断到 NANC 的时间[中位数，9（95%CI 9-11）vs. 11（95%CI 10-12）vs. 9（95%CI 8-12）天，P=0.15]、从用药到 NANC 的时间[中位数，9（95%CI 8-10）vs. 10（95%CI 9.48-11）vs. 8.708（95%CI 7.51-11）天，P=0.50]或住院时间[中位数，11（95%CI 11-13）vs. 13（95%CI 12-14）vs. 12（95%CI 10-14）天，P=0.14]均无统计学差异，即使在调整了性别、年龄、COVID-19 类型、合并症、Ct 值、从诊断到抗病毒治疗的时间以及症状数量后也是如此。阿兹夫定、莫努匹韦和奈玛特韦/利托那韦组第 5 天的累积 NANC 率分别为 15.2%/12.3%/16.0%（P=0.858），第 7 天为 34.8%/21.5%/32.0%（P=0.226），第 10 天为 66.7%/52.3%/60.0%（P=0.246），第 14 天为 86.4%/86.2%/80.0%（P=0.721）。未报告严重不良事件。在轻至中度 COVID-19 成年患者中，阿兹夫定在 NANC 时间、住院时间和 AEs 方面可能与奈玛特韦/利托那韦和莫努匹韦相当。
