Li Fangyu, Zheng Keao, Qi Xueyan, Cui Kaixia, Yang Jing, Hao Zhiying
School of Pharmacy, Shanxi Medical University, Taiyuan 030001, China.
Department of Pharmacy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital, Affiliated with Shanxi Medical University, Taiyuan, 030002, China.
J Cancer. 2024 Mar 4;15(8):2442-2447. doi: 10.7150/jca.91530. eCollection 2024.
Azvudine has been recommended as a potential treatment for the recently discovered Coronavirus disease (COVID-19) in 2019. However, the effectiveness of Azvudine in individuals who have both COVID-19 and pre-existing cancer remains uncertain. Consequently, we undertook a retrospective analysis to evaluate the clinical efficacy of Azvudine therapy in hospitalized patients with COVID-19 and pre-existing cancer. This is a single-center retrospective analysis of patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, selected from patients admitted to a specialist oncology hospital between June 1, 2022 to June 31, 2023 with positive RT-PCR and pre-existing cancer. After exclusion and propensity score matching, patients in the test group treated with Azvudine and control patients treated with standard antiviral therapy were included. The primary outcome is the interval time from the first dose of Azvudine to the attainment of the first negative result for nucleic acid. Secondary outcomes included the rate of nucleic acid conversion, the duration of hospitalization, and the admission to the intensive care unit (ICU). Cox proportional hazards models were used to analyze the hazard ratio (HR) of event outcomes and to assess whether cancer types and Azvudine treatment will affect the course of COVID-19, specifically the time it takes for primary symptoms to alleviate. In this study, a total of 84 patients were included for analysis. Among them, 42 patients received Azvudine treatment after hospitalization, and the rest were treated with standard antiviral therapy. The results expressed that the time taken for the first negative nucleic acid test was significantly shorter in the Azvudine group compared to the control group [5 (IQR3-7) d vs 12 (IQR9-15) d], 0.0001. This difference was statistically significant. Furthermore, a multivariate COX analysis indicated that Azvudine treatment could effectively reduce the time required for nucleic acid conversion in cancer patients (HR 1.994, 95% CI 1.064-3.736, =0.031). And the type of cancer also had an impact on the course of COVID-19 in patients. (HR 3.442, 95%CI 1.214-9.756, =0.020; HR 3.246, 95% CI 1.925-7.209, =0.036). Azvudine was correlated with a reduced duration for achieving nucleic acid conversion in individuals diagnosed with cancer. And different types of cancer have a certain impact on the course of COVID-19 for patients.
阿兹夫定已被推荐作为2019年新发现的冠状病毒病（COVID-19）的一种潜在治疗方法。然而，阿兹夫定在同时患有COVID-19和既往癌症的个体中的有效性仍不确定。因此，我们进行了一项回顾性分析，以评估阿兹夫定治疗对合并COVID-19和既往癌症的住院患者的临床疗效。这是一项单中心回顾性分析，研究对象为被诊断为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的患者，这些患者选自2022年6月1日至2023年6月31日入住一家专科肿瘤医院且RT-PCR检测呈阳性并患有既往癌症的患者。经过排除和倾向评分匹配后，纳入了接受阿兹夫定治疗的试验组患者和接受标准抗病毒治疗的对照组患者。主要结局是从首次服用阿兹夫定到首次核酸检测结果为阴性的间隔时间。次要结局包括核酸转阴率、住院时间和入住重症监护病房（ICU）的情况。使用Cox比例风险模型分析事件结局的风险比（HR），并评估癌症类型和阿兹夫定治疗是否会影响COVID-19的病程，特别是主要症状缓解所需的时间。在本研究中，共纳入84例患者进行分析。其中，42例患者住院后接受了阿兹夫定治疗，其余患者接受标准抗病毒治疗。结果表明，与对照组相比，阿兹夫定组首次核酸检测阴性所需时间显著缩短[5（IQR3 - 7）天 vs 12（IQR9 - 15）天]，P = 0.0001。这种差异具有统计学意义。此外，多因素COX分析表明，阿兹夫定治疗可有效缩短癌症患者核酸转阴所需时间（HR 1.994，95%CI 1.064 - 3.736，P = 0.031）。并且癌症类型也对患者的COVID-19病程有影响。（HR 3.442，95%CI 1.214 - 9.756，P = 0.020；HR 3.246，95%CI 1.925 - 7.209，P = 0.036）。阿兹夫定与确诊为癌症的个体实现核酸转阴的时间缩短相关。并且不同类型的癌症对患者的COVID-19病程有一定影响。
